Roommate Preference, if any (indicate commuting here if that applies)
Your answer
Any allergies that could be of concern during camp?
Your answer
Any special dining restrictions (such as no beef, no pork, no gluten, no dairy) that the cafeteria should know about?
Your answer
School Attended *
Your answer
Parents' Name(s) *
Your answer
Parents' Mailing Address (include city, state and zip code) *
Your answer
Parents' Phone Number *
Your answer
Emergency Contact Name/Number (in addition to parents)
Your answer
I hereby authorize the directors of Math Contest Camp to act for me according to their best judgment in any emergency requiring medical attention. I hereby waive and release SBU and Dr. Hopkins. I know of no mental or physical problems that might affect my child's ability to safely participate in this camp. I will be responsible for any medical or other charges in connection with his or her attendance at camp above and beyond the limited coverage of camp insurance. By entering your name below, you understand this qualifies as a signature for this authorization. *
Your answer
He/she is covered by the following insurance company. *
Your answer
A copy of your responses will be emailed to the address you provided.