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Campus Visits
March 2–4, 2017
Discover Rosedale Registration
Personal Data
First Name:
Last Name:
Primary Address:
Secondary Address:
Postal Code:
Phone Number:
Expected H.S. Grad Year:
High School:

Arrival time is Thursday evening between 8:00 and 9:30 PM. Departure is Saturday morning between 10:00 and 11:00 AM. If you need to arrive or depart earlier or later than the scheduled times, please indicate your plans below.
Expected Arrival Time:
Expected Departure Time:

Please list any food allergies or dietary restrictions that our food services staff should be aware of:

Medical Liability Waiver

Please have your parents complete and sign the Medical Liability Waiver. We ask all Discover Rosedale participants to bring a signed waiver along with them.


I grant Rosedale Bible College the right to take photos and record videos and sound files of me in connection with the Discover Rosedale event and to use such photographs of me with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and web content.

Group Data

If you are coming with an organized group, and know any of the following information, please complete this section. If you are making independent arrangments, this section does not apply.

Sponsor Name:
Sponsor Address:
Sponsor City, State, Zip:
Sponsor Phone Number:
Sponsor E-mail:

Names (if known) of others in your group:

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Rosedale Bible College
2270 Rosedale Road, Irwin, Ohio 43029
740-857-1311 | 877-857-1312 fax

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