APEX 2023 Registration

Complete this form to register for APEX 2023.

"*" indicates required fields

Step 1 of 3

Your Awesome Name*

First Last

Your Stellar Email Address*

Your Super Cool Phone Number*

Your Fantastic T-Shirt Size*

Gender*

Your Age at APEX 2023*

Please enter a number from 5 to 100.

Were you referred to APEX by a friend?*

Please enter the name of the person who referred you to APEX.*

State*

Student Status*

Major*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Will you need to ride the shuttle from the GRR airport to the APEX venue?*

Do you have any allergies or health concerns we should be aware of?*

Please select the most applicable*

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

APEX 2023 Early Bird Registration

Price: $0.00

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Payment secured by Stripe.

Credit Card*

Card Details

Cardholder Name

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