Thank you for your interest in GLAMPing! Registration Form Student Name* First Last Date of Birth* MM slash DD slash YYYY Gender* Female Male Prefer not to answer Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current Grade Level (at time of application) - Those who are entering 8th Grade are ineligible to apply for GLAMPing and should apply for Camp Connect.* 5th Grade 6th grade Shirt Size* Small Medium Large X-Large I have previously attended GLAMPing.* Yes No Current School* School District (Example: Orange, Seminole, Brevard, Volusia, etc.)* School Street Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Ethnicity* American Indian/Alaska Native Asian Black/African American Hispanic/Latino Multi-racial Native Hawaiian/other Pacific Islander White Prefer not to answer Parent/Guardian #1 Name* First Last Parent/Guardian #1 Phone*Parent/Guardian #1 Email*All communication for GLAMPing will be sent to this email. Please be sure the address is entered correctly. Parent/Guardian #2 Name(optional) First Last Parent/Guardian #2 Phone(optional)Parent/Guardian #2 Email(optional) Emergency Contact Name (Person other than Parent/Guardian #1)* First Last Emergency Contact Phone*Emergency Contact Email* How did you hear about this camp?* Mail Internet Search/Google Ad Facebook Guidance Counselor Teacher Friend Previously Attended GLAMPing Other (explain below) If "Other", explain here I am involved with the following clubs at school:* STEM Club Engineering Club Robotics Club Math Club None Other If "Other", explain here Explain why you are interested in attending GLAMPing. (To be completed by the student)*