2014 Summer Writing Camp Registration
Click here to download a paper copy of the registration form.

Contact Information


Student Name: (*)

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Age: (*)

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Grade student is entering in fall 2014: (*)

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School: (*)

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Parent/Guardian Name: (*)

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Home Address: (*)

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Primary Phone Number: (*)

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Work Phone Number:

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Additional Phone Number:

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Email Address:

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In Case of Emergency Contact Person: (*)

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Emergency Contact Phone Number: (*)

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List any allergies the student has: (*)

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Waiver

By typing your name in this box, you are indicating that you allow your student to participate in field trips. Also by typing your name in this box, you are waiving all rights to hold UAB or its staff responsible for any injuries or loss of property that occur on these field trips. This also includes any injuries or loss of property that may occur on the UAB campus. (*)

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Select your camp(s)

Middle School Camps are for students entering grades 5-8. High school camps are for students entering grades 9-12. You may attend as many weeks as you like within your age category. Please indicate which camp sessions you would like to attend (check all that apply)

Middle School Camps



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Required Camp Registration Fee (*)

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Method of Payment (*)

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Please enter the following characters: (*)

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