ZinkerzCamp | Coding Journey S'25

Camp Date
Date

MonthDayYear
Date
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Parent Phone*

Country CodePhone Number
Student Name*

First NameLast Name
Student Email*
example@example.com
Student Phone*

Country CodePhone Number
Country*
Country
Date of Birth*

MonthDayYear
Passport Copy*

Cancelof
Headshot Photo (to be used in our camp directory)*

Cancelof
Expiration Date*

MonthDayYear
What is your T-Shirt Size?*

XSSML
T-Shirt Size
Arrival & Departure Info

If you have purchased your flight tickets please provide us with the details. If you have not, please let us know as well.
I don't have my flight tickets yet.
No worries! You'll be able to submit your flight itinerary after registering.
Arrival Flight (Boston inbound Flight only)

Students are asked to arrive on July 9th, 2025 between 9:00am and 7:00pm to ensure shuttle service from the airport or train station.

Arriva outside of this window will require your own transportation.
Airline
Flight Number
From
To
Flight Date & Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Departure Flight (Boston outbound Flight only)
Airline
Flight Number
From
To
Flight Date & Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Roomate Requests?

We will do our best to honor these requests
Please list any special requests about rooming:
Roommate #1

First NameLast Name
Roommate #2

First NameLast Name
Roommate #3

First NameLast Name
Activities
Fun Activities: Please indicate which type of activities you'd like to do.

ShoppingHistorical sitesMuseums (art, natural history, science)Food-Oriented (tours, visits to local spots, etc)Boston Favorites (Fenway Park, Boston neighborhoods, Hockey game)Entertainment (movies, comedy shows, music)Sports (rock climbing, ice skating)Recreation (laser tag, escape the room)

College Tours: During ZinkerzCamp, we will have the opportunity to visit some of the colleges and universities in the area. Please rank the following schools in order of your interest

	Very Interested 1	Interested 2	Neutral 3	Less Interested 4	Not Interested 5
Boston University
MIT
Harvard
Brandeis
Babson
Northeastern
Tufts
Brown
Bentley
Dartmouth

Dietary Restrictions
Do you have any food allergies we should know about?*

YesNo
Please specify*
Medical
Do you have any health problems, allergies, and/or conditions we should know about?*

YesNo
Please be as specific as possible. It is for your safety. This information will be kept confidential*
Upload Student's Medical Insurance Card with Coverage in the US (front & back)*

Upload multiple files at once
Cancelof
I authorize Zinkerz Staff to give my child Advil or Tylenol during camp should they need it*

YesNo
Waiver

Please sign below the following Waiver Forms. You will get a copy to your email after submitting.
ZinkerzCamp Waiver*
Dormitory Waiver*
Rules & Guidelines
Student Signature*

Clear
Parent/Guardian Signature*

Clear
In case of emergency, whom should we contact?
Same as parent
Name*

First NameLast Name
Emergency Contact Phone*

Country CodePhone Number
Relationship to Student*
Additional Information
Do you have any other special needs, requirements or comments?*

YesNo
Please specify*
Payment

Please confirm your attendance by submitting your payment.

ZinkerzCamp: College Journey - Summer 2025 Product Image

ZinkerzCamp: College Journey - Summer 2025(Full Payment)

$4,900.00

ZinkerzCamp: College Journey - Summer 2025(Two Payments: One Now and one in March 2025)

$4,900.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Date

MonthDayYear
Date
Should be Empty:

Arrival & Departure Info

Roomate Requests?

Activities

Dietary Restrictions

Medical

Waiver

Additional Information

Payment