Language Immersion Camp Enrollment Form
Enroll for an immersive language learning experience. Please complete all sections for camp participation.
Participant's Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Participant's Email Address
*
example@example.com
Participant's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Guardian's Full Name (if participant is under 18)
First Name
Last Name
Guardian's Phone Number (if participant is under 18)
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select the language immersion program you are enrolling for
*
Please Select
Spanish
French
German
Mandarin Chinese
Japanese
Other
Please indicate your current proficiency level in the selected language
*
Beginner
Intermediate
Advanced
List any medical conditions, allergies, or medications we should be aware of
*
Do you have any dietary restrictions or food allergies?
Will you require camp accommodation?
*
Yes
No
Will you require transportation to/from the camp?
*
Yes
No
Signature of Participant or Guardian
*
Submit Enrollment
Submit Enrollment
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