2024 PWB Summer Camp Registration Student Name First Name * Last Name * Grade Level * 7th 8th Freshman Sophomore Junior Senior Please select the grade your student will enter in the 2024-2025 academic year. Date of Birth * Please enter student's DOB. Must be at least 12 years of age by start of 2024-25 school year to participate in this camp. What is your interest in attending this camp? * Please let us know if we need to provide any individualized options for your child. * Special Accommodations (mobility challenges, medical conditions, etc.) Known Food Allergies/Sensitivities (nuts, gluten, etc.) Vegetarian Meal None Other If you selected "Other," please specify: Additional Comments: Parent/Guardian First Name * Last Name * Email * Emergency Contact * Please enter contact name and relationship to the child. EXAMPLE: Jane Smith, aunt Emergency Contact Phone * How'd you hear about us? Source Please tell us how you learned about this summer camp. (Online search, HBA member recommendation, Teacher/Guidance Counselor, etc.)