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Georgia DeMolay University
Georgia FFA-FCCLA Center, Covington GA
January 19-21, 2018
Registration Closes: January 5, 2018
Please Note: * indicates a required field
What registration package would you like?
Leaders' Academy Package - $50.00 C3PO Package - $50.00 Life Skills Training Package - $50.00
Do you have a voucher for a registration discount?
Name on Badge:
Please ensure that your e-mail address is correct.A confirmation of your transaction will be sent to this e-mail address.
Date of Birth:
All fields in this section are required. Check the "uninsured" box if you do not have medical insurance.
Policy Holder Name:
No refunds will be granted after January 5.
Advisor Approval Required
An advisor from the registrant's Chapter must attend the event to supervise this registrant, if the
registrant is an active DeMolay or another young man for which supervision would be appropriate.
For a Sweetheart, Rainbow, or Minor Female Guest, an advisor must select a qualified, approved chaperone
to attend to supervise the Sweetheart or minor female guest. An advisor of each Chapter will be contacted
approximately two weeks prior to the event to approve all registrants for that Chapter. If the advisor
does not approve a registrant to attend the event for a valid reason, a full refund will be issued and
the registrant will not be allowed to attend the event.
DeMolay Functions are drug, alcohol, and weapon free. Georgia DeMolay reserves the right to search any
bag or room for cause. Registrants who are in possession of prohibited items will be removed from the event
In the event of injury or illness to my son, daughter, or ward, I hereby authorize and direct DeMolay advisor(s)
supervising the activity in which the above named youth is participating, to secure medical treatment, including,
but not limited to, hospitalization, injections, anesthesia, and surgery for my son, daughter, or ward; thereby
authorizing a supervising DeMolay advisor to sign and consent thereto as fully as I could were I personally present.
I acknowledge that I will be responsible for payment of all charges related to the medical services provided.
As parent or guardian of the registrant, I further agree to indemnify and hold harmless the Associated DeMolay
Chapters of Georgia (aka Georgia DeMolay), and any adult advisors and/or volunteers who have agreed to supervise
the activity for which my son, daughter, or ward is registering, from any damages recovered or recoverable by my
son, daughter, or ward. Furthermore, I agree that, upon notification from an authorized adult DeMolay advisor or
other volunteer assisting with the event at which my son, daughter, or ward is a participant, to remove my son,
daughter, or ward, if, in the opinion of the supervising adults, it is deemed necessary and appropriate that
he/she be removed from the activity site. I also agree on behalf of my son, daughter, or ward that, if it is
deemed necessary by DeMolay advisors supervising the activity, his/her room may be entered and an inventory of
his/her personal effects performed by no fewer than two DeMolay advisors. By allowing registrant to attend the
event, I fully understand the above and agree to abide by its terms.
"By entering my name below, I hereby state that I am over 18 years old and the legal guardian of the registrant listed above.
I have read and agree to all of the above terms and conditions."
(be sure to read all terms and e-sign above before clicking "Continue")
Online Event Registration and Payment
Last Modified: 22 November 2017
Copyright © 2017, Georgia DeMolay