Health Sciences Camp Registration

Dates: July 15, 16, and 17, 2024
Cost: $250 Includes room, food and all activities.

Camper Information

Camper Name(Required)

First Last

Camper Email(Required)

Enter Email Confirm Email

Camper's School in Fall 2024(Required)

Please tell us the school where the camper will be enrolled in Fall 2024.

Camper's Grade in Fall 2024(Required)

Please tell us the grade the camper will begin in Fall 2024.

Camper's Age at Time of Camp(Required)

Please tell us how old the camper will be as of July 15, 2024 when the camp begins.

Camper's Cell Phone Number(Required)

The camper's phone number will only be used during the camp.

Camper's Legal Sex(Required)

Federal guidelines mandate that we collect the legal sex of all applicants. Please report the sex currently listed on the camper's birth certificate.

Camper's Gender Identity

If camper's gender identity differs from the sex currently listed on their birth certificate, please share that information here.

Parent or Legal Guardian Information

Parent or Legal Guardian's Name(Required)

First Last

Parent or Legal Guardian's Email(Required)

Enter Email Confirm Email

Emergency Contacts

Name of Primary Emergency Contact(Required)

First Last

Primary Emergency Contact's Relationship to Camper(Required)

Primary Emergency Contact's Phone(Required)

Name of Secondary Emergency Contact(Required)

First Last

Secondary Emergency Contact's Relationship to Camper(Required)

Secondary Emergency Contact's Phone(Required)

Health Statement

Please list any and all physical conditions that Boise State program staff should know which may affect or be affected by participation in this program.

Present medical problems or conditions(Required)

If none, please enter "None."

Medications taken regularly(Required)

If none, please enter "None."

Allergies(Required)

If none, please enter "None."

Limitations on physical activities(Required)

If none, please enter "None."

Health Insurance Information

Policy Holder's Name(Required)

First Last

Policy Holder's Relationship to Camper(Required)

Policy Holder's Phone Number(Required)

Policy Holder's Employer

Insurance Company(Required)

Group Number

Member Number

Insurance Card Front Copy

Please upload an image of the front of the insurance card. JPG, GIF, PNG, and TIFF files are allowed as long as they are less than 9 MB

Accepted file types: jpg, jpeg, gif, png, tiff, Max. file size: 10 MB.

Insurance Card Back Copy

Please upload an image of the front of the insurance card. JPG, GIF, PNG, and TIFF files are allowed as long as they are less than 9 MB

Accepted file types: jpg, jpeg, gif, png, tiff, Max. file size: 10 MB.

Payment

The registration fee of $250 includes the cost of lodging and food for three days and two nights and activities.

When you click the submit button, you will be redirected to our payment portal. You must pay the registration fee in order for your registration to be considered complete.

You should receive TWO emails when your registration is paid and complete.

The first email will be to the camper's email address and to the parent/legal guardian's email address and will come from COHS@boisestate.edu.
The second email will be a receipt for payment and will be sent to the email address that you enter on the final screen of the payment portal. This email will be sent from Marketplace-Receipts@boisestate.edu.

If you do not receive both emails, please contact COHS@boisestate.edu.

Health Sciences Camp Registration

Camper Information

Parent or Legal Guardian Information

Emergency Contacts

Health Statement

Health Insurance Information

Payment

College of Health Sciences