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Young Writers Camp Application/Registration
Please complete the information below to register for Young Writers Camp. We will send you a confirmation email with details on camp and paying the registration fee as listed below.
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What camp are you registering for?
*
Creative Writing at Girls, Inc. Carpinteria (July 16-27)
Creative Writing in Digital Spaces at UCSB (July 9-20)
Creative Writing at CLU (July 9-20)
Creative Writing at UCSB (July 9-20)
What is your registration type?
*
Girls Inc Member Registration (if your child is a Girls Inc. member) ($0)
Regular Registration Carpinteria ($325)
Sibling Registration Carpinteria (if you already have one child enrolled) ($300)
Regular Registration CLU/UCSB ($375)
Sibling Registration CLU/UCSB (if you already have one child enrolled) ($350)
Junior Teacher Registration (For Grades 10+) ($0)
What is your name (parent/guardian name)?
*
Your answer
What is your full address?
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Your answer
What is your work phone number?
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Your answer
What is your home phone number?
*
Your answer
What is your email?
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Your answer
List Any Additional Email Addresses (For YWC Notifications)
*
Your answer
Child Name
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Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Gender
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Female
Male
Prefer not to say
Other:
Child's Name As It Should Appear on Anthology
*
Your answer
School in September 2018
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Your answer
Grade in September 2018
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Choose
3
4
5
6
7
8
9
10-12 (For Junior Teaching Applicants)
T-Shirt Size
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Child Small
Child Medium
Child Large
Child XL
Adult Small
Adult Medium
Adult Large
Adult XL
Share any special emotional or educational needs our teachers and staff should know about your child.
Your answer
List any medical problems or special needs that our teachers and staff should know about your child.
Your answer
Child's Physician
*
Your answer
Physician's Phone Number
*
Your answer
Emergency Contact's Name
*
Your answer
Emergency Contact's Phone Number
*
Your answer
Emergency Contact's Relationship to Child
*
Your answer
List the Full Names of All Other Adults Authorized to Pick-up Your Child
*
Your answer
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