Registration

2018 Pacific Northwest DLC
July 15th - 21st

Attendee's Name *

First

Last

Nickname *

Attendee Phone # *

Email *

Parent's Name *

Emergency Contact *

Parent's Phone # *

Emergency Phone # *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Chapter Advisor's Name *

Advisor's Phone # *

Food Allergies... *

My Jurisdiction *

Birthdate (mm/dd/yyyy) *

Age *

Chapter Name *

Current Office *

Previous Offices Held *

Shirt Size (adult) *

Have you received your RD? *

Did you receive a Jurisdictional Scholarship? *

None $100 $200 $300

Highest LCC Completed *

Have you been to DLC before? *

No Once Twice Three or more times

Please download a copy of the Medical Release / Parental Consent and fill it out completely. Once you have your form complete and signed by both the attendee and his parents/guardian you will need to scan it and attach it here. You will not be able to register for DLC without it. If you have questions about this feel free to contact us.

If you have already registered and simply need to submit a payment click the button.

2018 Pacific Northwest DLC
July 15th - 21st

Medical History:

Click Here to Download a
Medical Release/
Parental Consent Form

Payment info:

If you have already registered and simply need to submit a payment click the button.

2018 Pacific Northwest DLC​July 15th - 21st

Medical History:

Click Here to Download aMedical Release/​Parental Consent Form

Payment info:

2018 Pacific Northwest DLC
July 15th - 21st

Click Here to Download a
Medical Release/
Parental Consent Form