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  • Accepted file types: jpg, pdf, docx.
  • Parental Consent

  • Click here and fill out the form with a signature from your parent/guardian. Please send the signed form to victoria@iccusa.org
  • Medical & Dietary Information

  • Click here and fill out the Medical & Dietary Form. Please send the signed form to victoria@iccusa.org
  • Registration Payment

  • Price: $1,750.00
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    As a non-profit, we must charge a 5% fee, for any payments made by credit card. If you would like to pay by check or wire transfer, please contact us for more information.
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Parent/Guardian Consent:
If applying through the ASLFL website, you must send a signed consent form to victoria@iccusa.org.

Photograph and Film Footage Release Statement:
I give my consent to the ICCUSA Foundation, Inc. to publish and use photographs and film footage taken of my son/daughter (as named above) at the Albert Schweitzer’s Leadership for Life Conference. All materials become the property of ASLFL and may be used, without further permission, for publicity purposes including print, television or web based sources. If you have any queries in relation to the above condition, please contact ASLFL at: victoria@iccusa.org to discuss the matter.

 

Contact Information:
Albert Schweitzer Leadership for Life
219 South Street – Suite 101
New Providence, New Jersey 07974

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