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Registration and Release Form (DHS RULE 117) Date: Student's Name: Program Name: Program Date Male Female Date of Birth Age Street Address: City: State: Zip: Phone: (H) (W) Cell Email EMERGENCY CONTACT

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2. Carefully read the instructions provided with bdhsb to understand the necessary steps involved in filling it out correctly.
3. Begin by entering your personal details in the designated fields of bdhsb. This may include your full name, date of birth, address, and any other requested information.
4. Provide your contact information, such as phone number and email address, ensuring that it is accurate and up-to-date.
5. If there are any specific sections or fields that require additional information, make sure to provide the necessary details accordingly.
6. Double-check all the information you have entered to ensure its accuracy and completeness.
7. If there are any supporting documents required to be attached with bdhsb, make sure to prepare them and submit them along with the form.
8. Review the filled-out bdhsb form one final time to confirm that all the information provided is correct and in accordance with the instructions.
9. Finally, submit the bdhsb form according to the instructions provided, whether it be electronically or through mail.

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