Careers in Health Science Summer Camp

* indicates required field

Student Information

Student Legal First Name

Student Preferred First Name (only if different from Legal Name)

Student Legal Last Name

Student Birthdate

Gender

Female

Male

Student Mailing Address (Please include Apartment # if applicable)

Country

Street

City

Region

Postal Code

Student Email Address

Confirm Email Address

Student Cell Phone Number

Home Phone Number (if available)

Opt in for texting

Yes

No

Parent/Guardian Information

With whom do you reside? This will be our point of contact for your registration.

Parent

Guardian

Parent Type

Father

Mother

Step-Father

Step-Mother

Parent First Name

Parent Last Name

Parent Email

Parent Cell Phone

Guardian First Name

Guardian Last Name

Guardian Email

Guardian Cell Phone

Academic and Interest Information

Select as list populates

If you are a Home School student, please type below: Home School Clearing House

Current School

Year you will graduate from high school

Major of Interest

Additional Information

Medical Scrub Top Size (Unisex)

Medical Scrub Bottom Size (Unisex)

T-shirt Size

Do you have any food allergies or dietary restrictions?

Yes

No

Please describe

Do you or anyone in your party require an accommodation in order to fully participate in this event?

Yes

No

Please describe required accommodation(s).

Did anyone refer you to this camp?

Yes

No

Please add the name of the person who referred you.

Payment

Are you interested in a need-based grant to cover the partial cost of this camp?

Yes

No

What is the amount of the grant that you would like to receive?

What is the name of your school counselor?

Will you be staying overnight in one of our residence halls for the duration of the camp?

Yes

No

Do you qualify for a free or reduced lunch?

Yes

No

Does paying for this camp impact your family's financial situation?

Yes

No

Please select one of the below payment options.

I will submit my $50 deposit at this time. I understand I will be sent an invoice for the remaining balance that is due by July 1, 2026.

I will pay the camp fee of $695 in full at this time.

I will pay the camp fee of $495 in full at this time.

For all credit card payments, a processing fee of 2.3% plus $0.30 per transaction will be applied.
For ACH/checking account payments, a fee of $0.25 USD will be charged per transaction and a fee of $1.00 will be charged per one-time payment for required ACH bank validation and verification. Presently only available in the U.S.

Amount Due
Transaction Fee	Dependent on selected payment type
Total	Dependent on selected payment type
Loading...

Amount Due

Transaction Fee

Dependent on selected payment type

Total

Dependent on selected payment type

Loading...

Event attendees acknowledge they may be photographed and that those photographs may be edited, altered, exhibited, or published for use in King’s College marketing materials. If any attendee wishes not to be photographed, please notify the event organizer or disclose this to the photographer.