Chaperone Attendee Information
Full Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
School/Organization Name
(Required)
Role/Title
(Required)
Dietary Information
Do you have any dietary restrictions?
(Required)
None
Allergy
Vegetarian
Vegan
Gluten-Free
Other
Please specify any other dietary restrictions or allergies.
Students
Please list the names of the student(s) you will be attending the conference with below.
(Required)
Please note that each student from your school or organization must fill out the youth RSVP form. Youth form:
Media Consent
Please read carefully before signing. We want to use your name, picture, and voice in photos and videos. These will be used to show what we do at the GCSADVHT. What you're saying YES to: We can use your name, picture, and voice in photos and videos. We can use these for a long time, even after you're done with the GCSADVHT. We won't pay you for this. You can change your mind: You can decide if you don't want us to use your name, picture, or voice. Just let us know by emailing us at gcsadvht@mass.gov.
Do you consent to the information listed above?
(Required)
Yes
No
Parking
Details linked above.