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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 - $400Summer 2025 - Middle School -$350Summer 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

Last Name

Primary Physician Phone Number

How will the student travel home? *DriveParent Pick-upUber/LyftAnother StudentAlternative (walk, bike, bus, etc.)

Emergency Contact First NameThis person is Authorized to pick up your student

Emergency Contact Last Name

Emergency Contact First NameThis person is Authorized to pick up your student

Emergency Contact Last Name

Emergency Contact First NameThis person is Authorized to pick up your student

Emergency Contact Last Name

Additional Information0 / 180

Photo/Video Release *YesNoI give consent for my teen's photo/video to be taken during camp activities for promotional purposes.

Student Shirt SizeX-SmallSmallMediumLargeX- Large2X3XShirts are adult sizes.

Agreement *I agreeBy 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

CheckboxApply $50 Discount

Total to Pay

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