WorldStrides

* Designates required field

Participant Information

Participant First Name *

Participant Last Name *

Birth Date *

Gender *

Graduation Year *

Email Address

Primary Contact Information (Student’s parent, guardian, or authorized legal representative)

First Name *

Last Name *

Country *

City *

Address *

Address 2

State / Province / County *

Province / District

Zip / Postal Code *

Email Address *

This email address will be used to create your WorldStrides account and access it in the future. A temporary password will be emailed to you. This will also be the email address used for communication and updates from WorldStrides.

Home Phone

Mobile Phone *

Check this box to receive important program information via text messaging.**

How did you hear about us? *

Additional Information *

How did you hear about us? * - select -

By submitting this form I confirm that I am at least 13 years of age, and provide my written consent for WorldStrides to contact me using email or telephone - including the use of automated technology and pre-recorded messages for calls to any wireless or residential telephone number I provide. This consent is not required to purchase goods or services.

**Available in the U.S. only. Message and data rates may apply. You may opt-out of text messaging at any time by replying STOP.

Rice ELITE Tech Camps

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Participant Information

Participant and Primary Contact Information

Participant Information

Primary Contact Information (Student’s parent, guardian, or authorized legal representative)