School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Advisor Name *

First Name

Last Name

Primary Advisor Phone Number *

(###)

###

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Secondary Contact Name *

First Name

Last Name

Secondary Contact Phone Number *

(###)

###

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Background Check Acknowledgement *

To ensure the safety of our delegates, all in person delegations are required to have at least one advisor or guardian that has completed a background check present on conference day. If an advisor/guardian attended WIRC XII, they do not have to complete the background check a second time. All new advisors/guardians are required to complete a background check and send it to cape@au-wirc.com. Please complete and submit the background check form before submitting the registration form. Once completed please check the box below to certify. The background check form is located at the bottom of this page.

I have read, understood, completed, and submitted the background check form to cape@au-wirc.com

Terms and Conditions *

Please read all terms and conditions and then check the box below to certify. The terms and conditions are located at the bottom of this page.

I have read the terms and conditions above and agree to them.