PWB Summer Camp Registration Student Name First Name * Last Name * Grade Level * 6th 7th 8th Freshman Sophomore Junior Senior Please select the grade your student will enter in the 2022-2023 academic year. 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 * HBAGC Membership Info Company Name / Member Contact * Please tell us the member company you work for and/or who recommended this camp program to you.
