📅 Friday, November 6, 2026

🕘 1:00 PM – 5:00 PM

📍 Humble, TX (Lychner Unit)

RSVP for LCFL27 Big Idea Pitch

"*" indicates required fields

Comments

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

Name*

First Last

Your Company*

Email*

We need your email address for us to reach you back.

The best way to describe me is:*

Business Owner

Business Executive

Spiritual Leader

Educator

Student

Retired

Passionate Community Member

Your Name EXACTLY as it appears on your drivers license or passport*

If you go by Tom but your Drivers License says Thomas, please enter “Thomas.”

First Last

Phone Number*

Cell phone is preferable. Required for event-related communications, such as an emergency that requires an event rescheduling.

Required Security Info

Have you attended an In-Prison PEP event before?*

I am a returning in-prison volunteer

I am a first time in-prison volunteer

Which government ID will you use to verify your identity?*

Drivers License

Passport

Have you completed TDCJ Training*

Yes

Please verify that the date on this identification is still valid through the date of the event(s) you selected above.*

Yes, the date on my identification is valid through the date(s) of the event(s) above

Drivers License or Passport Number*

Drivers License State*

Passport Country of Issuance*

Country

Do you have a family member or friend currently housed within a TDCJ Facility?*

(If so, we may need to secure special approval from the warden for your visit.)

Yes

If yes, which facility?*

Have you ever served time in a TDCJ Facility?*

Have you ever served time in a TDCJ Facility? (Select NO if you only served time in TYC and/or county jail).

Yes

If YES, please list the facility where you served time and your release date.

(If NO, please skip this question.)

If YES, are you still on parole?

Yes

ADDITIONAL CONTACT INFO

How did you hear about PEP?*

Your Preferred First Name*

For example, if the name on your driver’s license is Robert Smith but you go by “Bob,” please write “Bob Smith.”

Your Title

What is your industry or functional expertise?

Other Phone

Any other line you would like to provide us.

Please provide your address as it appears on your drivers license.*

Street Address Address Line 2 City State ZIP Code

Medications / Medical Devices

Will you need to bring any medicine/medical devices into the Unit with you?*

EX: insulin, inhaler, oxygen tank, wheelchair, etc.

Yes

Please provide a detailed description, including any drug prescription name(s)*

Waiver of Liability and Media Release Agreement

Please read and indicate your agreement.*

Please read and indicate your agreement. IN CONSIDERATION for being permitted to participate in activities of the Prison Entrepreneurship Program (“the Program”), THE UNDERSIGNED, for himself/herself, his/her personal representatives, heirs and next of kin: 1. Agrees that he/she appreciates the risk of injury during his/her participation in the Program and further agrees that he/she assumes full responsibility for his/her own safety and for determining that no dangerous conditions exist that could affect his/her own safety at any of the sites; 2. Agrees that his/her participation in the Program acknowledges that he/she finds the sites as being reasonably safe for the purpose of his/her use, and further agrees that if, at any time he/she feels anything to be unsafe, he/she will immediately withdraw from the dangerous area; 3. Acknowledges that in the course of his/her participation during in-prison events or other PEP sponsored activities, video or photographs may be taken or illustrations may be made of him/her and further agrees to allow, without compensation, his/her likeness to appear in material, regardless of media form, promoting the Program, its events and activities, including those of its representatives and licensees; 4. Releases, waives, discharges and covenants not to sue Prison Entrepreneurship Program or any subdivision thereof, and each of them, their officers and employees, (hereinafter as “Releasees”) from all liability to the undersigned, his/her personal representatives, assigns, heirs and next of kin for any and all loss or damage and any claim or demands therefrom on account of injury to the person or property or resulting in death of the undersigned en route to/from the site, in or upon the site or while observing, working for or participating in the Program; 5. Agrees to hold harmless and to indemnify the Releasees from and against all claims, actions, damages and expenses, including but not limited to reasonable attorney’s fees for any alleged injury and/or death to any person or damage to any property arising or alleged to have arisen out of any negligent, reckless or intentional act of the undersigned or failure to act on the part of the undersigned, his/her heirs, successors or assigns; and 6. Agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by laws of the State of Texas and that if any portion thereof is held invalid, the balance shall continue in full legal force and effect. I have read and voluntarily signed this Waiver of Liability and Media Release Agreement and further guarantee that no additional oral representations, statements or inducements have been made.

I Agree to the above Waiver of Liability and Media Release Agreement

Lychner Winter 2027 Big Idea Pitch – RSVP

RSVP for LCFL27 Big Idea Pitch

Required Security Info

ADDITIONAL CONTACT INFO

Medications / Medical Devices

Waiver of Liability and Media Release Agreement