Student Name *

First Name

Last Name

Parent/Guardian Name *

First Name

Last Name

Phone Number (To receive text messages until conclusion of camp)

(###)

###

####

Student Grade (for Fall 2023) *

6th

7th

8th

Gender *

Male

Female

How did you find out about AYM Summer Boost Camp?

Google

Social Media

Friend

Mentor

AYM / Interhigh

Flyer / Poster

Peachjar

Other