2024 Summit - Student Registration
2024 FBA Leadership Summit Application - April 18-21, 2024 - Haines City, FL

One student per form.  Complete all pages of this form.  Applications are accepted without regard to race, creed, color or religious preference.  Registration is non-refundable after March 01, 2024.  STUDENTS MUST BE ACCOMPANIED BY AT LEAST ONE ADULT FROM THEIR DISTRICT (TEACHER, COUNSELOR OR HBA MEMBER).  THE ADULT WILL BE CONSIDERED PART OF THE STAFF AND WILL BE EXPECTED TO REMAIN ONSITE FOR THE DURATION OF THE SUMMIT.  
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First Name *
Last Name *
Nick Name
Street Address *
City *
State *
Zip Code *
Student Cell Phone Number ( Write N/A if you don't have one) *
Student Email Address (Write N/A if you don't have one) *
Current Grade *
Date of Birth *
MM
/
DD
/
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Age as of April 18, 2024 *
Gender *
School Name *
FBA Chapter Officer? *
Teacher or FBA Chapter Advisor *
T-Shirt Size *
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