Student Leadership Conference Registration

The Student Leadership Conference has been postponed to a yet to be determined date in Spring, 2017.
More information will be sent to schools when the new date has been finalized.
Date of Activity: April 27-28, 2018

Location: North Haven High School, 221 Elm Street, North Haven, CT 06473

Hotel: Best Western Plus, 201 Washington Avenue, North Haven, CT 06473

Registration Deadline: April 23, 2018

Please fill out the following form to submit your registration. In addition to submitting this form each participant must print, fill out and bring the Student/Parent Code of Conduct Form and the Student Medical Form with them to the conference (you will be able to download the forms after submitting your registration).

Enter names as "First Last" not "Last, First" (i.e. Robert Smith). DO NOT use all capital letters.

You must bring one advisor for every twelve (12) students. If more than 12 students will be attending you must submit an additional registration form which includes the new adult's name.

All students must be accompanied by a registered adult throughout the conference. Students arriving without a registered adult advisor will be denied access to all conference activities and refunds will not be issued. Due to food and hotel guarantees, notification of cancellations must be made to CAS no later than 4 p.m. on April 23, 2018. Refunds will not be available for non-attendance or for cancellation after 4 p.m. on April 23, 2018.
 
School Info
School:
Address:
Town:
Zip Code:
 
Payment Info
Form of Payment (enter "Check" if sending check or P.O. number if paying via purchase order):
Pricing:

Two Day Conference Fee With Housing:
* $100 per student (quad occupancy)
* $100 per advisor (double occupancy)
* $145 per advisor (single occupancy)

Two Day Conference Fee Without Housing:
* $75 per student
* $75 per advisor

Non-CAS Member Schools:
* Additional $100 per non-member school
 
Adult Advisor
Name:
Title:
E-Mail Address:
Gender: MF
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Hotel Room Type: Single Room Shared Room
Student #1
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #2
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #3
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #4
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #5
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #6
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #7
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #8
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #9
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #10
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #11
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
Student #12
Name:
Title:
Home Phone Number:
Emergency Contact Name and Number:
Gender: MF
Grade: 9 10 11 12
Vegetarian: Yes No
List Any Food Allergies (if none enter "N/A"):
T-Shirt Size: S M L XL XXL
 
Room Assignments -- List the names of students who will be sharing a room. You can assign up to four students per room.
Room #1:
Room #2:
Room #3:
Room #4: