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Niagara Falls Trip Registration
Thank you for your interest in the Niagara Falls Trip!
Please feel free to reach out to Michelle Andrews- Smith (
mandre20@ur.rochester.edu
) or Breanna Dauphinee (
bdauphin@ur.rochester.edu
) with any questions.
Thank you once again!
Contact Information
Name:
*
First Name
Last Name
Affiliation:
*
select one
Alumni
Friend
Graduate Student
Local Resident
Parent
Parent of Alumni
Undergraduate
Class Year:
Example: 2019
Email:
*
Verify Email
*
Mobile Phone:
Dietary Restrictions:
Please list any dietary restrictions you may have.
Emergency Contact Information
Parent/Guardian Name:
*
First Name
Last Name
Parent/Guardian Email:
*
Verify Email
*
Parent/Guardian Mobile Phone:
Payment/Miscellaneous Information
Please choose one of the following options regarding payment:
*
Please email Breanna (bdauphin@ur.rochester.edu) or Michelle (mandre20@ur.rochester.edu) if you have any questions or require a scholarship.
I will pay the $20 trip fee to Michelle/ Breanna (a $10 deposit is required at the time of registration, with the remaining $10 paid by the date of the event).
I will pay the $20 trip fee via Venmo @URNewman (a $10 deposit is required at the time of registration, with the remaining $10 paid by the date of the event).
I will need a scholarship.
Do you have a car and would you be willing to drive?
*
Niagara Falls State Park is approximately an hour and a half drive from campus (we will reimburse you for fuel).
select one
Yes
No
Parent/ Guardian Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country