Register for Explore, Make and Discover in the Big Sky

Sunday, June 19 to Saturday, June 25, 2016

Sorry, the camp has been cancelled.

* = required

Student Information

* Student First Name:
Student MI:
* Student Last Name:
* Address:
Address, line 2:
* City:
* State or Province:	Please Choose Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory
* Zip Code:
* Country:
* Student Phone:
* Student Email:
* School:
* Grade in Fall 2016:	Please Choose 10th Grade 11th Grade 12th Grade
* Birthday: (Use mm/dd/yyyy)
* Gender:	Please Choose Female Male Other
Special Needs:

Parent Information

* Parent Name(s) (First and Last):
* Email:
* Home Phone:
* Work Phone:
Cell Phone:

Please fill any additional contact information for a second parent in the comments box below.

Registration Fee

You may either pay:

• In full: $1059 ($200 is non-refundable)
• A non-refundable $200 deposit with the balance due by May 6

*	Please Choose Pay in Full:  $1059.00 Pay a $200 deposit now and the balance later

You will pay in the next screen. We accept Mastercard and Visa.

Comments

Comments:	(Include contact information for a second parent)