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Student First Name
*
Student Last Name
*
Student Phone Number
Parent Phone Number
*
Email Address
*
Age
Grade Rising
Session/s Enrolling
*
Summer 2025 - High School - $400
Summer 2025 - Middle School -$350
Summer 2025 - All Girls -$400
Emergency Contact First Name
*
Emergency Contact Last Name
Emergency Contact Phone Number
*
Emergency Contact Email Address
Known Allergies (food, medications, etc.)
0 / 180
Pertinent Current Medications (if any)
0 / 180
Pertinent Medical Conditions (if any)
0 / 180
Does your teen have any special needs or accommodations we should be aware of?
0 / 180
Is there any other information you would like to share with us to ensure a positive camp experience for your teen?
0 / 180
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
Last Name
Primary Physician Phone Number
How will the student travel home?
*
Drive
Parent Pick-up
Uber/Lyft
Another Student
Alternative (walk, bike, bus, etc.)
Emergency Contact First Name
This person is Authorized to pick up your student
Emergency Contact Last Name
Emergency Contact First Name
This person is Authorized to pick up your student
Emergency Contact Last Name
Emergency Contact First Name
This person is Authorized to pick up your student
Emergency Contact Last Name
Additional Information
0 / 180
Photo/Video Release
*
Yes
No
I give consent for my teen's photo/video to be taken during camp activities for promotional purposes.
Student Shirt Size
X-Small
Small
Medium
Large
X- Large
2X
3X
Shirts are adult sizes.
Agreement
*
I agree
By signing this form, I certify that all information provided is accurate and complete to the best of my knowledge. I understand that this information will be used for the purposes of organizing and ensuring the safety of my teen during their participation in the camp activities at I-Present. I also understand Cancellations made before June 1st, will receive a 50% refund along with a $25 processing fee. Cancellations made after June 1st are non-refundable. No refunds or reimbursements will be offered for missed days of camp.
Date
*
Coupon Code
Checkbox
Apply $50 Discount
Total to Pay
Submit Registration!
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