Select Your Camp Timberlake Blue Ridge & Equinunk Tyler Hill
Parent First Name:	Parent Last Name:
Parent Email:
Parent Phone:
Student's First Name:	Student's Last Name:

Grade Select Grade Entering Senior Year after camp Entering Junior Year after camp Entering Sophomore Year after camp	Sex: Select Male Female
Approximate (Weighted) Grade Point Average:	Extra Time Accommodations: Select None Time and a half Time and a half multiple days Unlimited Breaks Double time Double time multiple days

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How did you hear about us:
Select Woodbury Magazine Internet Friend

We ask for a $250 deposit (first session payment) to secure a spot in the program. We accept checks made out to Future U, cash, or Venmo to the following address Jordan-stadler-2.