Registration Form - June Term Activities Registration 2015

June 13-27, 2015
Note: No refunds will be made after June 13.

Note: Red * text indicates required fields

Registrant Information

First Name, Last Name *
Address Line 1 *
Address Line 2
City, State, Postal Code *
Phone Number *
Cell Phone Number
Email Address *


All students participating in activities other than the dinner on campus must complete the Family Medical Information form found at the Summer School web site.
All off site activities include transportation. Food costs are only included for dinner on campus, Young's Run (one of three options), and Custard at Ritters. Please select the activities for which you are registering:
A waiver form is required to participate in this activity. Please check the Summer School web site for the appropriate form for the canoe trip and/or climbing wall.

Payment Information

Total Amount: $