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Princess Campus Care Package Winner Form

Congratulations on being selected! Please complete the form below to help us prepare your care package and connect you with additional support services.

Winner Information

First name

Last name

Phone

Address

College Information

File upload

College/University You Will Be Attending

Would you like assistance with dorm move-in?

Would you like to be included in our college mentorship program?

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Phone Number

Event RSVP

I acknowledge that in order to receive a care package, I must attend Princess and a Pad’s Back-to-School Giveaway on July 19, 2025, between 3:00 p.m. and 4:00 p.m. at Carl Rhodenizer Recreation Center, located at 3499 Rex Road, Rex, GA 30273.

Medical, Photography, and Liability Release Waiver

By signing below, I acknowledge and agree to the following:

Medical Release: I certify that I am in good health and able to participate in any activities associated with Princess and a Pad events. I authorize Princess and a Pad and its representatives to obtain emergency medical treatment in case of illness or injury. I release Princess and a Pad from liability in seeking such medical care.

Photography & Media Release: I give permission for photographs and video taken of me during Princess and a Pad events or services to be used in publications, social media, promotional materials, and the organization’s website. I waive any rights to compensation or ownership of such images.

Liability Waiver: I release and hold harmless Princess and a Pad, its staff, volunteers, partners, and affiliated entities from any and all claims, damages, losses, or liabilities arising from or related to my participation in any programs or services, including care package delivery, dorm move-in support, or event attendance.

Signature of Winner

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Date

Month

Day

Year

Signature of Parent/Guardian

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Date

Month

Day

Year