jCAMP at JMU July 14-18, 2019 REGISTRATION FORM
Please complete all required fields. You will be registered when your check made payable to VAJTA is received. Send to VAJTA, c/o Erinn Harris at 501 N. Armistead Street, #102, Alexandria, VA 22312. Early Bird fee (by March 1) - $475; Regular Registration fee (by May 1) - $525; Late Registration Fee (by Jun 1) - $575. After we receive your check, we will send you a release form for you and your parents to sign and return plus a list of things you will need for camp and information about arriving at JMU on July 14.
Last Name *
Your answer
First Name *
Your answer
I will be coming to camp as a *
Male or Female? *
Home address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Phone Number *
Make sure you list phone number where we can most easily reach parents for emergency purposes
Your answer
Parent email address *
Your answer
student email address *
Your answer
school name *
Your answer
school city *
Your answer
school state *
Your answer
participant's date of birth *
xx-xx-xxxx
Your answer
What grade will you be in in the fall of 2019? *
who do you request as your roommate? *
Allergies/health concerns/special diet? *
Enter none if you don't have any
Your answer
t-shirt size *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service