UTD Getaway 2025 The Getaway Registration Name* First Last Email* Phone*Sex* Female Male Will you be at least 18 years old on 10/04?* Yes No: YOU WILL NEED TO GET A MINOR RELEASE FORM FROM A STAFF MEMBER Are you a part of a Core group? If so, which one?* I am not part of a Core. Shree and Devereaux Renae and Elle Kaitlyn and Ella Briana and Presley Sharin and Victoria C. Lauryn and Victoria N. Portia and Claire Jenna and Rachel Ruth and Lily Alexis and Janice Ava and Cassie Sarina and Nyellie Arianna and Brooklin Kayla and Madeline Elaine and Sarah Meron and Mckayla Whitney and Erfa Andrea Sabrina and Priscilla Jessica Brian and Wilson Juke and Lucas Gavin and Jake Jaiden and Will Rohit and Jason Jeremiah and Kai Felipe and Paul James and Carson Juan and Logan Marlon and Diego Peder and Travis Joey Emiliano and Klein Nahom and Kole Caden and Xander Isaac and Jack Emergency Contact Name* First Last Emergency Contact Phone*Please list any dietary restrictions herePlease list any medications or conditions we should be aware of in case of an emergencyWill you need financial assistance to be able to attend The Getaway?* Yes No Will you be staying overnight?* Yes No Which days will you be attending?* Saturday Only Sunday Only Saturday and Sunday (not spending the night) Would you like to pay for The Getaway online now? (You can also pay in person at The Getaway.)* Yes, I will pay for The Getaway now. - $40 No, I'll pay later. Would you like to pay for The Getaway online now? (You can also pay in person at The Getaway.)* Yes, I will pay for The Getaway now. - $25 No, I'll pay later. Would you like to pay for The Getaway online now? (You can also pay in person at The Getaway.)* Yes, I will pay for The Getaway now. - $15 No, I'll pay later. Would you like to pay for The Getaway online now? (You can also pay in person at The Getaway.)* Yes, I will pay for The Getaway now. - $30 No, I'll pay later. If you would like to include a scholarship to help other students pay for The Getaway, you can enter the amount here. *Once everyone is paid for, any leftover funds will be transferred to the general fund to further the mission of FOCUS. Credit CardCard Details Cardholder Name Total $0.00
