Registration Form - Nursing Camp 2014

June 23-27, 2014
Registration Deadline: June 16, 2014
The Nursing Camp requires a registration fee of $400.00 per person. Your registration cannot be confirmed until your credit card information is processed or payment is received in the mail.
Registration fees are not refundable after the registration deadline.

Exchanges/Changes to Registration
Please do not re-register when wanting to exchange or change your registration. All changes must be submitted by email to events@cedarville.edu or by phone at 1-877-CEDARVILLE (233-2784). Please include name of registrant, organization name, contact information and your desired changes. We will be happy to help in any way that we are able.

Cancel Registration and Return to Nursing Camp Home

Note: Red * text indicates required fields

Title *
First Name, Last Name *
Address Line 1 *
Address Line 2
City, State, Postal Code *
Country
Phone Number
[999-999-9999 x999]
*
Parent/Guardian Work Phone Number
[999-999-9999 x999]
*
Cell Phone Number
[999-999-9999 x999]
Email Address *
School Name *
School City, State *
Church Name *
Church City, State *
Birthday (00/00/0000) *
Grade in School (September 2014) *
T-Shirt Size *
How did you hear about Academic Camps? *   
  
  
  
  
  

Travel Information


Housing Information

*

Special Dietary Needs

Please let us know of any allergies that would require special meals to be prepared for you in our cafeteria. All special meal requests must be accompanied by a letter from your doctor.

Special Housing Needs

Please let us know of any disabilities/medical conditions that would require special housing needs.

Payment Information

Total Amount: $