Media Production 101 – Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmail *Parent or Legal Guardian Name *FirstLastParent or Legal Guardian Phone *School Attending 2023-2024 *Grade level 2023-2024 *High School Grade 10High School Grade 11High School Grade 12Recent Graduate (16-19 years of age)T-Shirt Size *S – Adult SmallM – Adult MediumL – Adult LargeXL – Adult X-LargePlease list any food allergies:For payment, please mail or drop off a check to: 319 Wayne Ave, Defiance OH, 43512. (Please make checks payable to DCCC) Submit