BOLT at Disney Registration Form

Includes a 3-day Disney park-hopper ticket (a $550 value), a Disney “Imagination Campus” program, 3 days of BOLT programming, an evening Disney theme park VIP special event, 3 days of breakfast and lunch, 3 BOLT t-shirts, and discounted hotel rates and theme park tickets available to parents/chaperones of students.

Choose the registration that fits for you.*

Add a Companion 3-Day Park Hopper pass ($450)?

yes
no

Add a companion ticket for our an evening Disney theme park VIP special event?

Registration Details

Guardian Name*

First Last

Guardian Email*

Guardian Phone Number*

Student Name*

First Last

Student Email*

Student Phone Number*

Student Home Address*

Street Address Address Line 2 City State ZIP Code

Student Age*

As of 6/1/2024

Student First Name*

As it should appear on a nametag

Student Current Grade*

Name of School Student Attends*

Student T-Shirt Size*

How many times (including this BOLT session) have you attended BOLT?*

Does student have any food allergies or restrictions?*

This information will be sent to Disney Culinary Services to meet your dietary needs. (If none, please enter "None.")

Does student have any non-food allergies (e.g. bee stings, medications, fabrics)?*

(If none, please enter "None.")

Companion Name*

Please enter the name of the companion who will be accompanying the registered student.

First Last

Companion Email

(If different from Guardian Email above.)

Companion Phone Number

(If different from Guardian Phone Number above.)

Coupon

Total

$0.00

Early Bird registration rates require a completed purchase order or check/credit card transaction by Dec. 20, 2024. If paying by check or credit card and you wish to pay in two installments, an initial deposit of at least 50% must be made by Dec. 20, 2024 — and the full final payment must be made by March 20, 2025.

Standard Registration rates registration require a completed purchase order or a check/credit card transaction for the full amount by March 20, 2025.

If not paid in full at registration, invoices will be sent for payment. For check or credit card registrations, installment payments must be made according to the above timeline in order to retain the discounted rates. If full payment is not made by March 20, 2025 for Early Bird or Standard registration, the Late Registration cost will be applied. For BOLT program attendance and participation, all registrations require full payment no later than May 31, 2025. After that date, any unpaid registration may be cancelled.

Cancellation Requests

Cancellation and/or refund requests must be submitted to Pegasus Springs Education Collective by email no later than May 1, 2025. Registrants who are unable to attend may either designate a non-registered person to attend in their place or request a refund. A $35 processing fee will be charged for each registration refund.

After May 1, 2025, registrants may only transfer their registration to a non-registered person to attend the event in their place, with registration confirmation or written authorization from the original registrant. No refunds will be issued after May 1, 2025.

Permissions and Notifications

By registering and attending this event, you understand that at this event and/or related activities, you and/or your child/student may be photographed. As an attendee/participant in the event or activities, you agree to allow your and/or your child’s/student’s photo, video, or likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.

Pegasus Springs Education Collective is a nonprofit organization. As part of the resort agreement for this event, Pegasus Springs Education Collective receives an $11 rebate for each room night at the hotel occupied and paid for by event coordinators and attendees at the group room rates during the dates of the designated room block. All funding from any rebate that is generated is used to offset expenses associated with offering this specific event to participants and attendees.

By participating in the event, you consent for you and/or your child/student to receive medical treatment that may be deemed advisable in an emergency or in the event of injury, accident, and/or illness during this activity or event. You are aware that there is no health insurance coverage associated with this event or activities and that participants should carry their own health insurance. If medical treatment is needed as a result of participation in this activity or event, travel to and from the activity or event (including air travel), or any activity incidental to this event, you agree to be financially responsible for any costs incurred as a result of such treatment.

By registering, you certify that you are voluntarily participating in this event and assume all risks for you, and/or your child/student, and/or anyone using a registration or ticket arranged by you to participate in this event. You are agreeing to release, indemnify, and hold harmless from any and all liability or claims the Pegasus Springs Education Collective and its partnering organizations — including their respective officers, directors, representatives, employees, contractors, coordinators, subcontractors, group leaders, volunteers, successors, assigns, insurers, and agents. (For students, parents or guardians will also be asked to complete an emergency contact/medical form and sign the Terms & Conditions agreement to authorize each child’s/student’s participation.)

Payment Options

Please select your preferred payment option:*

Pay In Full Now (Proceed to PayPal)
Payment in Three Installments with credit card (we will invoice you)
Purchase Order or Group Registration Package (we will invoice you)

Purchase order number or group name

Name for invoice

First Last

Email for invoice

Address for invoice

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Terms and Conditions*

To complete this registration for the BOLT 2025 program at the Walt Disney World Resort, click below to acknowledge that you understand and agree to the terms and conditions.

I am authorized to register this student or participant. I have read and agree to all terms and conditions, including the BOLT Terms & Conditions, the Walt Disney World Property Rules, and the Walt Disney Word Resort’s Terms & Conditions for Theme Park Reservations.

Phone

This field is for validation purposes and should be left unchanged.

BOLT Student Leadership Program At Disney REGISTRATION

Registration Details

Payment Options