2017 EMS Debate Camp - Student Application
To have your child participate in this year's camp please complete and submit the application below by Sunday, June 11, 2017. If you have any questions regarding this application, please contact EMS program manager Leslie at 410-752-2835 x 106 or by email budlcamp@budl.org. We look forward to receiving your application!
Student Information
Student First Name
Your answer
Student Last Name
Your answer
Student Phone Number
Your answer
Home Address
Your answer
City
Your answer
Zip Code
Your answer
School 2017-2018 School Year
Your answer
Student ID/SASI
Your answer
Grade 2017-2018 School Year
Birth Date
Your answer
Gender
Your answer
Race/Ethnicity (optional)
Select all that apply
Indicate any dates this summer your child is UNAVAILABLE to attend camp.
Media Release
Do you give permission for BUDL to use photos or video of your child for league publicity, such as on our Facebook page or in brochures/publications?
Parent/Guardian Contact Information
Parent or Guardian Name
Your answer
Parent or Guardian E-mail Address
Your answer
Home Address
Your answer
City
Your answer
Zip Code
Your answer
Primary Phone Number
Your answer
Alternate Phone Number
Your answer
Student Debate Experience
Has child ever debated?
Did your child attend any BUDL tournaments in the 2016-2017 School Year?
How many BUDL tournaments did your child attend during the 2016 - 2017 season?
What division was your child in for his/her last tournament?
Did your child attend BUDL debate camp last summer?
Summer Camp Student Code of Conduct
Parents/Guardians - Please read this code of conduct with your child and ensure you and they understand the expectations.

All BCPSS policies are in effect during summer camp. Students must:
(1) Show courtesy and respect toward others and property at all times.
(2) Dress appropriately at all times.
(3) Use appropriate language.

Statement of Disciplinary Action
The following are examples of disciplinary action which may be taken in the event that the Code of Conduct, school policies, or district policies are not followed:
(1) Sent home immediately at parent/guardian's expense.
(2) Placed in timeout/in-camp suspension.
(3) Referred to school administration.

STUDENT AGREEMENT: I, the student, understand the conditions of the code of conduct.
Please check below that you understand, Yes or No.
Student Signature
Please type your name below, as your signature, to indicate you have read and understood the code of conduct.
Your answer
PARENT/GUARDIAN AGREEMENT: I understand the conditions of the code of conduct.
Please check below that you understand, Yes or No.
Parent/Guardian Signature
Please type your name, as your signature, below to indicate that you have read and understood the code of conduct.
Your answer
Medical Information and Release
We are requesting this information, which will be kept strictly confidential, in order to ensure your child's safety throughout the duration of our camp.
Health Disclosure
Please note any health concerns such as allergies (please specify), hemophilia, diabetes, heart disease, etc. Also list special dietary needs/restrictions, food allergies, etc. If none, type none.
Your answer
Medical Insurance Provider
Your answer
Policy or ID Number
Your answer
Family Doctor/Primary Care Physician
Your answer
Phone Number of Doctor/Primary Care Physician
Your answer
Emergency Contact
In case of emergency when you cannot be reached by phone who would you like us to call as your alternate?
Provide full name, other than you, below.
Your answer
Emergency contact's relationship to student
Your answer
Phone Number
Your answer
Transportation to Camp Survey
Please indicate your transportation plans to camp.
Referral Information
Please help us know how you find information about BUDL by filling out this portion of the application, so that we may continue to communicate effectively with you you and your child.
How did you hear about this year's camp?
Required
If you heard about camp from a friend, please list his or her name below.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Baltimore Urban Debate League. Report Abuse - Terms of Service - Additional Terms