KAPPA LEAGUE APPLICATION

Austin Kappa League Membership Application

For young men ages 13–18. Complete this application to begin your journey with the Austin Alumni Chapter's flagship Guide Right youth program.

Applicant Information
Information about the young man applying for membership.
Parent / Guardian Information
Primary contact for the applicant.
Emergency Contact
Demographic Information
Academics
Interest Level
Medical Information
Emergency Medical Information
In case of emergency, where would you prefer your child be transported?
Membership Dues

Annual Dues: $250.00 — due by August 1st. A payment of $125.00 must be received before the Induction Ceremony.

Required Acknowledgements
Each acknowledgement requires the appropriate party to type their full name as a digital signature. The submission timestamp serves as the date of signature.

News Release / Program Promotion Waiver. I give permission to the Austin Guide Right Program and the Austin (TX) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. to use or release any photos of my child, taken solely for the purpose of promoting the Fraternity and its Guide Right Program.

Release for Medical Treatment. In the event of an emergency, and the inability of the Austin Kappa League staff to obtain my consent, I hereby give permission for the members of Austin (TX) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. to authorize any medical treatment or surgery which a physician or surgeon shall deem necessary for my child.

Parental Acknowledgement. I hereby give my permission for my child to become a member of the Austin Kappa League. I understand that the Austin Guide Right Program and the Austin (TX) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. is not responsible for personal injury or loss of property. I understand that the payment of yearly membership dues is required and that $125.00 will be due before the Induction Ceremony. I understand my child can / will be expelled from the Austin Kappa League at any time due to misconduct, with no monies refunded.

Application Acknowledgement. I wish to become a member of the Austin Kappa League and I promise to be careful to prevent damage to any buildings used while participating in activities. I agree to obey the rules and bylaws of the Austin Kappa League. I represent that all answers and information furnished are true and correct, and I understand that any incorrect or false information may result in automatic rejection. If approved, I agree to comply with the program's rules and regulations.

* Required fields