Campus Visit Registration

Name Name First Last
Email
Cell Phone Number
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
How did you hear about Providence?

How did you hear about Providence? Email Postcard College/School Fair Athletic Coach / Recruiter Social Media (Facebook, Instagram, Twitter, etc.) WORLD Magazine Christian Renewal Magazine Aquilla Report Other Other
Sign up for a planned visit day

Sign up for a planned visit day Friday, February 16, 2024 Friday, March 22, 2024 Friday, April 19, 2024 Friday, May 3, 2024 I would like to schedule a personal visit
(Our Admissions staff will contact you soon to schedule a suitable visit day)
I am a

I am a First-time Freshman Transfer Student
High School Graduation Year
High School Attended
My parents will accompany me

My parents will accompany me Yes No
Name of parent(s) attending
Would you like to stay overnight?
(if yes, an Admissions Counselor will contact you regarding details)

Would you like to stay overnight?
(if yes, an Admissions Counselor will contact you regarding details) Yes No
Extra-Curricular Interest/Athletics
The Academic Program that I am MOST interested in exploring is:

The Academic Program that I am MOST interested in exploring is: Business, Economics, and Entrepreneurship (BEE) Biblical and Theological Studies (BTS) Education (EDU) Health and Life Sciences (HLS) Communication, Media And Arts (CMA) Philosophy, Politics, and History (PPH) Psychology (PSY) Undecided
Please list any known allergies that we should be aware of:
PLEASE FILL OUT THE INFORMATION BELOW FOR
OVERNIGHT GUESTS ONLY

Waiver Form

All overnight visitors to Providence must sign the waiver. If under 18 years of age, a parent or guardian signature is required.
By signing below, the participant (or parent/guardian if participant is a minor) does hereby release, forever discharge and agree to hold harmless Providence Christian College and its officers, employees, and agents, from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the above-described trip or activity. Furthermore, I (we) [and on behalf of my (our) child-participant if a minor] hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission is hereby given to said college to furnish any necessary transportation, food, and lodging for this participant. The undersigned further hereby agree to hold harmless and indemnify said college, its administration, employees, and agents, for any liability sustained by said college as the result of the negligent, willful, or intentional acts of said participant, including expenses incurred attendant thereto. If the participant is a minor: I (We) am the parent(s) or legal guardian(s) of this participant, and hereby grant my (our) permission for him (her) to participate fully in said activity or trip and hereby give my (our) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, I (we) hereby assume all transportation costs. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable arbitration process.
Your Name
Your Signature: (draw your signature into the box below)

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Full Name
Date Date / MM / DD YYYY
Name of parent or guardian (if student is under 18 years of age)
Parent signature: (draw your signature into the box below)

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Full Name

Campus Visit Registration

Campus Visit Registration

PLEASE FILL OUT THE INFORMATION BELOW FOR OVERNIGHT GUESTS ONLY Waiver Form

PLEASE FILL OUT THE INFORMATION BELOW FOR
OVERNIGHT GUESTS ONLY

Waiver Form