Student Registration Form

Sorry, but this form is now closed. For questions you may e-mail mpm_thinks@msn.com or

text 410-746-2746.

Student First Name

Student Last Name

Grade Level

School Attending

Parent Phone

Parent/Guardian Email

Emergency Contact Name and Number

List any Food Allergies

What size T-shirt do you wear?

Is transportation assistance needed for student?

Are you a PTA/PTSA member?

Workshop Session 1 - 9:30AM - 10:25AM (First Choice)

Workshop Session 1 - 9:30AM - 10:25AM (Second Choice)

Workshop Session 2 - 11:30AM - 12:25PM (First Choice)

Workshop Session 2 - 11:30AM - 12:25PM (Second Choice)

Workshop Session 3 - 1:30PM - 2:25PM (First Choice)

Workshop Session 3 - 1:30PM - 2:25PM (Second Choice)

Workshop Session 4 - 3:30PM - 4:25PM (First Choice)

Workshop Session 4 - 3:30PM - 4:25PM (Second Choice)

We will interview students, facilitators, and volunteers, chronicle successes, and make a video of the summit. Parents of minors, do we have parental permission to videotape or photograph your student? Answers will be verified with a parent.

If you desire a participation waiver in lieu of providing $15 please list your PTA/PTSA member number or email a photo/screenshot of family membership or individual membership to mpm_thinks@msn.com. (You may be able to find in GiveBacks of your PTA unit)

Summit General Information

A light fare breakfast & lunch and will be served.

Students are responsible for their own transportation.

Students attending workshops or volunteering qualify for up to 8 hours of service-learning.

Students must pick up registration materials and obtain a service-learning form at the event

Parents, guardians or caregivers must authorize student participation.

Parents will be contacted with registration information provided.

Registration information will not be provided to third parties.