Chaperone Registration Form
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Email *
School Name *
Your Name *
Cell # *
T-Shirt Size *
Required
Do you have any allergies, dietary restrictions, or mobility restrictions? *
Are you interested in participating in a panel discussion or being a presenter for faculty or students? If so, what would you like to do? (If not, no worries!) *
Chaperone Responsibilities
Thank you for agreeing to serve as a chaperone. Please review your responsibilities below, and sign electronically below to indicate that you have read and agree to adhere to the policies outlined below.  We will see you at the chaperone briefing when you arrive at the event.

If you have any questions, please contact Dina Marks at marksd@ensworth.com or (615) 564-0864.
Chaperone Responsibilities
As chaperone, I:

1. Will obtain and have available all parent permission, emergency contact and medical release forms and provide them prior to the conference;

2. Am fully responsible for the actions and whereabouts of said youth at all times;

3. Will discuss the purpose and importance of this conference with said youth, including the common sense/good behavior etiquette including cell phone and messaging courtesy which is expected at national, educational events such as this conference;

4. Will review and discuss all material covered in this chaperone briefing with the said youth (non-adherence to conference policies, such as property damage, excessive noise after hours, breaking of curfew, etc.) can result in sanctions, from requiring me to accompany said youth to ALL conference events, to asking me and/or said youth to leave the conference.

Please sign electronically below to show that you have read and understand the chaperone responsibilities. *
A copy of your responses will be emailed to the address you provided.
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