UBC Physics & Astronomy Outreach

This is the registration form for the UBC Physics Outreach summer camps.
Please fill out the information fields below - All fields are required, except for an alternate Phone Number.

If the camp you are hoping to register for is full and you would like to receive information about our summer camp program earlier next year, please subscribe to our outreach newsletter

The waiting lists for the following camps are full: Advanced Physics (July 18-22), Chemistry Physics & Astronomy (July 18-22), and Fun with Physics (July 25-29).

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Student Information
First Name of Camp Participant
Last Name of Camp Participant
Age of Camp Participant
Grade Completed by Student this June (Participating students must finish at least Grade 1 by June 2011)
Gender of Student
T-Shirt Size
Allergies / Medical Alerts of Camp Participant
MSP Number
Does your child have any special needs we should be aware of?

Parent Information
First Name of Parent/Guardian
Last Name of Parent/Guardian
Phone Number
Alternate Phone Number
House Address (Please include city and Postal Code!)
E-mail address
All children are expected to be picked up by their parent or legal guardian. If your child is to be picked up by someone other than the parent or legal guardian, please identify the individual below and his/her relationship to your child. How would you like to receive the summer camp welcome letter, which includes important information regarding drop off/pick up time and location, what the child needs to prepare for the camp, and additional scuba diving consent form (if applicable)? I, as the parent or guardian of the camp participant, give UBC Physics & Astronomy Outreach Program the permission to use images depicting my child involved in camp activities for our website & print materials (e.g. flyers). I understand that my child's name will not be associated with any image used by the Outreach Program in this manner. YesNo How did you hear about this camp?

Emergency Information.
Please note that emergency contact information should not be the same as parent information. We will only contact the emergency contact person if we are unable to reach the parent/guardien specified in the section before.
Emergency Contact Full Name
Emergency Contact Phone Number

Consent and Waiver

In the event of an accident or injury, I give my consent to the staff of the summer camp program to provide emergency first aid to my child. I will be responsible for any medical or other charges in connection with his/her treatment or attendance at the camp. I am aware that there is a certain risk of injury involved in my child's participation in camp activities. By agreeing to these statements, I waive and release any and all right and claim for damages of any sort or any other claim or remedy of any sort I may have against the University of British Columbia, its directors and its staff, in connection with my child's participation in this camp.

Yes, I have read and agree with the statements above.