Participant Emergency Contact and Medical Form

Download the Participant Emergency Medical Form (PDF)

Upon acceptance to the Institute, please return this form and the Participant Information Form no later than May 15. Please include the $130 registration fee (and $40 lodging fee if you indicated Sunday lodging). All fees non-refundable after May 30. Checks should be made payable to Roanoke College. 

Send to: 
Ms. Linda Lindsay 
Roanoke College, Education Department
221 College Lane
Salem, VA 24153