January Augustinian Day Registration

We are thrilled to welcome you to campus January 31-February 1 for our Augustinian weekend. The information you provide here will help us to best prepare for your visit. Please carefully answer every question, so we can plan a great experience for you!

Note that the program begins at 8:00 a.m., January 31, and concludes at 4:30 p.m., February 1.

Student's Email Address

Student's First & Last Name (how you would like it to appear on your name tag)

Student's Mobile Phone Number

First Parent/Guardian Name

First Parent/Guardian Relation

First Parent/Guardian Best Contact Method

First Parent/Guardian Phone

First Parent/Guardian Email

I would like to include a second parent/guardian contact.

Second Parent/Guardian Name

Second Parent/Guardian Relation

Second Parent/Guardian Best Contact Method

Second Parent/Guardian Mobile

Second Parent/Guardian Home Phone

Second Parent Guardian Work Phone

Second Parent/Guardian Email

Emergency Contact Information. If you wish to provide an emergency contact other than your parents, do so here.

How many guests will be joining you?

0

1

2

Names of Guests Attending

Who will be attending Friday evening's semi-formal dinner with you?

Do you or your guests have dietary restrictions?

Yes

No

List the dietary restrictions for you and your guests.

Will you need local transportation to and/or from Westmont?

For students traveling alone, we are happy to provide transportation to/from the college.

Yes

No

Date of Pick Up

Time of Pick Up

Location of Pick Up

Santa Barbara Airport (SBA)

Los Angeles Airport (LAX)

Santa Barbara Train Station

Santa Barbara Airbus (LAX shuttle to downtown Santa Barbara)

Other

If other, please provide the location

Date of Drop Off - Please provide the date of your departure.

Time of Drop Off - Please provide the time of your flight, train or bus departure.

Location of Drop Off

Santa Barbara Airport (SBA)

Los Angeles Airport (LAX)

Santa Barbara Train Station

Santa Barbara Airbus (LAX shuttle to downtown Santa Barbara)

Other

If other, please provide the location of drop off

Extended overnight stay at Westmont

For students traveling alone, you are welcome to stay in a residence hall for additional nights. When will you need an extended stay?

Thursday Night

Saturday Night

Is there anything else you'd like us to know to best prepare for your arrival?

By submitting this registration form, I agree to the following:

1. As Participant, I understand that (a) behavior which disrupts the program or poses a threat to the safety of self or others will not be tolerated; (b) if I am unable to abide by Westmont's Behavioral Expectations, then, after the event sponsor (or its agent) has made a good faith effort to resolve the issue, I may be removed from the remainder of the event; and (c) in which case there will be no refund if the event required a registration fee. 2. If I am staying the night, I understand that I may go on excursions off campus. Such excursions may include riding in the Westmont Shuttle with current students to explore local points of interest such as downtown Santa Barbara, Stearns Wharf and West Beach. 3. If, in the opinion of the person in charge, an injury or illness requires urgent medical or dental examination or treatment, I authorize and direct that person (or their agent) to (a) arrange transportation by car or ambulance to the closest hospital and (b) attempt to reach the emergency contact listed. 4. I understand that Westmont College assumes no financial responsibility or legal liability for medical care or ambulance transportation. I also verify that I am in sufficient health to be able to participate in the event identified above. I recognize that all physical activity has some risk of injury or even death and, except for any negligence, on behalf of all interested parties I release Westmont from liability for such loss. 5. I authorize the use, in future program publications, of biographical, image, video or audio content recorded for or during event activities and which includes me.

I agree