NOMA Louisiana - New Orleans 2026 Project Pipeline Student Registration Form

Student #2 Name

First NameLast Name
Student #2 Gender
Student #2 Race
Student #2 Email
example@example.com
Student #2 School
Student #2 Age
Student #2 Grade Level in Upcoming Fall Semester
Student #2 Interests
Student #2 T-Shirt Size
Student #2 Dietary Restrictions
Has student #2 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #3 Name

First NameLast Name
Student #3 Gender
Student #3 Race
Student #3 Email
example@example.com
Student #3 School
Student #3 Age
Student #3 Grade Level in Upcoming Fall Semester
Student #3 Interests
Student #3 T-Shirt Size
Student #3 Dietary Restrictions
Has student #3 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #4 Name

First NameLast Name
Student #4 Gender
Student #4 Race
Student #4 Email
example@example.com
Student #4 School
Student #4 Age
Student #4 Grade Level in Upcoming Fall Semester
Student #4 Interests
Student #4 T-Shirt Size
Student #4 Dietary Restrictions
Has student #4 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #5 Name

First NameLast Name
Student #5 Gender
Student #5 Race
Student #5 Email
example@example.com
Student #5 School
Student #5 Age
Student #5 Grade Level in Upcoming Fall Semester
Student #5 Interests
Student #5 T-Shirt Size
Student #5 Dietary Restrictions
Has student #5 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #6 Name

First NameLast Name
Student #6 Gender
Student #6 Race
Student #6 Email
example@example.com
Student #6 School
Student #6 Age
Student #6 Grade Level in Upcoming Fall Semester
Student #6 Interests
Student #6 T-Shirt Size
Student #6 Dietary Restrictions
Has student #6 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #7 Name

First NameLast Name
Student #7 Gender
Student #7 Race
Student #7 Email
example@example.com
Student #7 School
Student #7 Age
Student #7 Grade Level in Upcoming Fall Semester
Student #7 Interests
Student #7 T-Shirt Size
Student #7 Dietary Restrictions
Has student #7 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #8 Name

First NameLast Name
Student #8 Gender
Student #8 Race
Student #8 Email
example@example.com
Student #8 School
Student #8 Age
Student #8 Grade Level in Upcoming Fall Semester
Student #8 Interests
Student #8 T-Shirt Size
Student #8 Dietary Restrictions
Has student #8 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #9 Name

First NameLast Name
Student #9 Gender
Student #9 Race
Student #9 Email
example@example.com
Student #9 School
Student #9 Age
Student #9 Grade Level in Upcoming Fall Semester
Student #9 Interests
Student #9 T-Shirt Size
Student #9 Dietary Restrictions
Has student #9 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?

Student #10 Name

First NameLast Name
Student #10 Gender
Student #10 Race
Student #10 Email
example@example.com
Student #10 School
Student #10 Age
Student #10 Grade Level in Upcoming Fall Semester
Student #10 Interests
Student #10 T-Shirt Size
Student #10 Dietary Restrictions
Has student #10 participated in Project Pipeline before? If yes, what year(s)?
Documentation As a parent or guardian of this student, I hereby consent to the use of photographs/videos taken during the course of the camp for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources) as well as survey information for camp reports and documentation. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.
Information Release
How did you hear about Project Pipeline?
Should be Empty:

Parent/Guardian Info