Northwood

Participant Details

First Name

Preferred Name

Last Name

Gender

Mobile Phone

Home or Alternate Phone

T-Shirt Size

Mailing Address

Country

Street

City

Region

Postal Code

Do you give Northwood University permission to text you about updates regarding this and other events on campus?

Academic Information

What year will you graduate High School?

What type of student will you enter college as?

Program of Interest

High School

Did anyone in your family attend Northwood University?

Yes

Family

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Cell Phone

What is the individual's relationship to you?

Country

Street

City

Region

Postal Code

Secondary Contact (Optional)

First Name

Last Name

Cell Phone

What is the individual's relationship to you?

Country

Street

City

Region

Postal Code

Health & Medical Profile

Primary Physician Name

Primary Physician Phone

Health Insurance Provider

Health Insurance Provider Number

Medical Needs & Allergies

Do you have severe allergies (Food, Medication, Insect Stings):

Yes

Please describe severe allergies

Do you carry an EpiPen?

Yes

Please describe dietary restrictions

Daily Medications / Medical Conditions:

Terms & Cancellation Policy

Full refunds will be granted for written cancellation requests received on or before Friday, May 28, 2027. Written cancellations after May 28, 2027, but prior to the first day of camp are eligible for a 50% refund. No-shows or cancellations made after the camp starts will not receive a refund. There is a minimum enrollment required for each camp to run. Should this minimum enrollment not be reached by Friday, May 28, 2027, the camp will be cancelled, and a full refund will be made to all who are registered.

Parent/Guardian Signature

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Amount Due
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Amount Due

Full Tank Registration - 2027