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Ohio District Circle K
Fall Rally Registration
2024 Circle K Fall Rally
"
*
" indicates required fields
Name
*
First
Last
Pronouns
*
Email
*
School/Club Name
*
Baldwin Wallace University (C72381)
Bowling Green State University (C71316)
Capital University (C71982)
Miami University (C70764)
The Ohio State University (C70162)
The Ohio State University, Lima Campus (C73378)
Ohio University (C71146)
Ohio Northern University (C73528)
Ohio Wesleyan University (C72802)
Shawnee State University (C73463)
Terra State Community College (C73540)
Tiffin University (C72921)
University of Cincinnati (C73451)
University of Toledo (C71786)
CKI Club in-formation
Kiwanis
Key Club
Aktion Club
Alumni
Guest
Other
Office Held
*
Club Member
Club Bulletin Editor
Club Committee Chair
Club Secretary
Club Secretary-Treasurer
Club Treasurer
Club Vice President
Club President
District Lt. Governor
District Committee Chair
District Officer
International Officer
Advisor
Kiwanis Member
Guest/Other
Emergency/Liability Information
Health Concerns
*
Emergency Contact
*
First
Last
Phone
*
Relationship
*
Parent/Guardian
Sibling
Other
Emergency Contact
First
Last
Phone
Relationship
Parent/Guardian
Sibling
Other
Liability Waiver
*
I hereby affirm that I have been well advised and thoroughly informed of the inherent hazards and policies of the event. I know that participating in this event is a potentially hazardous activity.
I also affirm that I will adhere to Ohio Wesleyan University’s rules, policies, and code of conduct. I recognize that I represent my school and Circle K International club and will act accordingly.
I agree to the liability waiver.
Lunch Order Form
Lunch: Sandwich Options
*
Lunch includes chips, dessert, fruit salad, and drinks. *Snacks and breakfast will be provided
Grilled Vegetable Hummus Wrap
Turkey Club
Chicken Caesar Wrap
Gluten Free Chicken Caesar Wrap
Dietary Restrictions
*
Registration Fee
Registration Fee
Quantity
*
Price:
$25.00
Quantity
Coupon
Total
How will you be paying?
*
Check
Credit Card
Credit Card
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.
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Fall Rally Registration