Two Week Curriculum – Overnight Camp

Disclaimer: Registration for this program requires submitting this form, completing your first payment and signing our release and agreement form. Once that’s complete you’re ready to travel!

Step 1 of 2

Parent/Guardian Name*
First Last
Parent/Guardian Email*
Parent/Guardian Phone Number*
Username*
Password*
Enter Password Confirm Password
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student Name*
First Last
Student Email*
Student Phone Number*
Student Date of Birth*
Date Format: MM slash DD slash YYYY
Student Gender*
Student T-shirt Size*
Grade Entering*
The following fields are not required to complete your registration for Project Fashion, however, they will need to be completed before June 1st, 2020 in order to attend the program. You can complete these fields by logging into your account after you complete your registration.
Photo of Student ID
Date of Arrival
Date Format: MM slash DD slash YYYY
Arrival Mode of Transportation
Arrival Flight Airline
Arrival Flight Number
Arrival Flight Time

: HH

MM
Do you need airport pickup?
Date of Departure
Date Format: MM slash DD slash YYYY
Departure Mode of Transportation
Departure Flight Airline
Departure Flight Number
Departure Flight Time

: HH

MM
Do you need airport dropoff?
Student Allergies (If there are no allergies, please indicate "None")
Student Dietary Restrictions (If there are no restrictions, please indicate "None")
Student Physical/Emotional/Mental Conditions (If there are no conditions, please indicate "None")
Medication
Medication Amount to Take Time to Administer OK to Self-Administer
Prescription Medication File Upload
Drop files here or
Please write a statement here that grants us authorization to obtain medical treatment should the need arise.
Insurance Company
Policy Number
Name of Policy Holder
Copy of Insurance Card
Are you an early bird or night owl? (Roommate matching question, day students can skip this question)
Generally speaking, do you keep your space well organized or messy? (Roommate matching question, day students can skip this question)
Do you have any other roommate preferences? (Roommate matching question, day students can skip this question)
Emergency Contact Name
Note: Your emergency contact information must be separate from the parent/guardian information submitted above.
First Last
Emergency Contact Email
Emergency Contact Phone Number

Full Name on Account
First Last
Email Address
Overnight Camp Payment Options*
Subtotal
$0.00
Add-ons Product
Add-ons
- Weekend extension (Day Camp Only):
- Airport pickup/drop off:
Coupon
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Full Session Name

Medication	Amount to Take	Time to Administer	OK to Self-Administer

Two Week Curriculum – Overnight Camp

Step 1 of 2

The following fields are not required to complete your registration for Project Fashion, however, they will need to be completed before June 1st, 2020 in order to attend the program. You can complete these fields by logging into your account after you complete your registration.

ADDRESS

CONTACT

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