High School & Beyond (Pittsburgh, PA) – Application


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Personal Information

Date of Birth*



As the parent or legal guardian of the participant identified on this registration, I hereby delegate authority to the Directors of "High School & Beyond" to arrange whatever medical treatment they deem necessary for him during the activity. Also, I hereby authorize and consent to the use and reproduction by YSI staff or an authorized agent or assignee of any and all photographs taken of the above-named applicant for the purpose of promoting YSI programs, without any compensation to me. All film, together with any prints, shall constitute property of YSI, solely and completely.
Who recommended this program to you?
Please include any dietary restrictions or medical conditions.
Write an essay (e.g., 200 words) on the following topic: “Who is your hero? How can this person’s life influence your high school career?” Applications submitted without an essay will not be considered. (We suggest the essay begin with a brief statement about your hero and why you admire this person. You might follow this with an anecdote that illustrates your hero's admirable traits, and then conclude by explaining how this person's life might influence your high school career.)

You may want to draft your essay prior to completing the online application and then copy and paste it into the box provided.