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Registration Form
Thank you for your interest in Peyvand's Summer Filmmaking Camp taking place at UW Seattle Campus Language Learning Center in Denny Building from August 17 to August 21, 2026 9:00 a.m. to 4:00 p.m. 

Participation is not confirmed until families complete all required registration and consent forms.  Please visit our website for more details and updates on the camp. 

Camp Tuition is $500. You may pay the tuition at our secure link here. **Tuition assistance, including full scholarships, is available to families who need it. Financial circumstances should not prevent an interested student from applying.  

Privacy Notice
The information collected through this registration form will be used only for administering the Youth Filmmaking Camp, determining scholarship eligibility, communicating with families, and complying with applicable legal and grant requirements. Personal information will be kept confidential and accessed only by authorized Peyvand personnel unless disclosure is required by law.

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How did you hear about this program? *
Youth's Full Name *
Youth's Age *
Grade level for the 2026–27 school year *
Parent/Guardian Name  *
Parent/Guardian Phone Number  *
Parent/Guardian Email *
Home Address *
How will the student arrive/depart? *
Authorized Pick up Person/s 
Include parent/guardian if they will normally pick up the student *
Authorized Pick up Person/s Phone Number/s *
 Primary Emergency Contact Name *
Primary Emergency Contact Relationship to the student *
Primary Emergency Contact Phone Number *
Secondary Emergency Contact Name  *
Secondary Emergency Contact Relationship to the student *
Secondary Emergency Contact Phone Number (other than parent) *
Does the student have access to a smartphone capable of recording video? *
Does the student have access to a laptop? *
Can the student attend all five camp days, August 17–21? *
Does the student need transportation assistance? *
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