4. 2026 Middle School Marquette WIC- Participant Registration

Jacobetti Complex

February 21, 2025

Student First Name

Student Last Name

School

Grade

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Please list any food allergies or dietary needs

T-Shirt Size

Parent/Guardian Information

Parent/Guardian Name

Relation

Parent/Guardian Mobile Phone #

Parent/Guardian Email Address (to where participation waiver will be sent)

Transportation Method (Participants are expected to self-transport to and from this event unless otherwise coordinated by the student’s school.)

Chaperone Information (if applicable)

Chaperone Name

Only complete this portion if the student will attend the event with a parent/teacher who will stay for the entirety of the event (not required)

Chaperone Phone #

Chaperone Email