Boston Reception 11.21.24 – Deerfield Academy

Registration Form

6:30 – 8:30 pm

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Contact Information

Name*

First Last

Primary Deerfield Affiliation*

(Please choose one)

Other Affiliation*

(Friend, Domestic Partner, Aunt, Uncle, etc.)

Class Year, if applicable

(Please choose one)

Email*

Daytime Telephone Number*

RSVP*

Do you have any food allergies or dietary restrictions?*

Please list all food allergies and dietary restrictions here:*

Please include any special conditions, or other requests or comments here.

Additional Guest?*

Guest Name*

First Last

Guest Affiliation to Primary Registrant*

(Please choose one)

Other Affiliation*

(Friend, Domestic Partner, Child, Aunt, etc.)

Guest Class Year, if applicable

(Please choose one)

Does your guest have any food allergies or dietary restrictions?*

Please list all food allergies and dietary restrictions here:*

Does your guest have any special conditions, requests or comments?

Admission*

(Please select the total number of Attendees)Minimum: 1. Maximum: 2.

Phone

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Contact the Office of Advancement

alumni@deerfield.edu | 413-774-1474

7 Boyden Lane, PO Box 87, Deerfield, MA 01342

NOTICE OF NONDISCRIMINATORY POLICY AS TO STUDENTS: Deerfield Academy admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.