Extreme Journey Registration

Camper/Student Information

Camper Name*

First

Last

Camper Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Camper Cell Phone*

If the student does not have a cell phone, please type 111-111-1111

Camper Home Phone*

Camper Email*

Name of School (2026-2027 School Year)*

Grade Level*

Please select the grade level student is entering in the 2026-2027 school year.

T-shirt Size*

Parent/Guardian Contact Information

Guardian 1 Name*

First

Last

This is the primary contact for the camper.

Guardian 1 Address (If different than camper)

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Guardian 1 Cell Phone*

Guardian 1 Home Phone

Guardian 1 Email*

Guardian 2 Name

First

Last

Guardian 2 Address (If different than camper)

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Guardian 2 Cell Phone

Guardian 2 Home Phone

Guardian 2 Email

Additional Authorized Guardians

*Additional authorized guardians are individuals (18 years or older) that parents/legal guardians have granted permission to transport their child(ren) to and from camp, if needed and/or make emergency medical decisions should a parent/legal guardian not be immediately available*

Authorized Guardian 1 Name

First

Last

Authorized Guardian 1 Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Authorized Guardian 1 Cell Phone

Authorized Guardian 1 Home Phone

Authorized Guardian 1 Email

In what capacity is this individual approved as an authorized guardian?

Transporting camper
Emergency medical decisions
Both

Authorized Guardian 2 Name

First

Last

Authorized Guardian 2 Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Authorized Guardian 2 Cell Phone

Authorized Guardian 2 Home Phone

Authorized Guardian 2 Email

In what capacity is this individual approved as an authorized guardian?

Transporting camper
Emergency medical decisions
Both

Camp Sessions

Please select the sessions your camper is attending.

Week 1, July 13-17, History’s Mysteries: The Art of Historical Detection

Price:
$450.00

Week 2, July 20-24, American Ideals: The Decisions that Changed America

Price:
$450.00

Week 3, July 27-31, Everyday Heroes: How Ordinary Americans Changed the Nation

Price:
$450.00

Discount/Scholarship Code

Total

$0.00

Credit Card

Forms Required*

I understand I will be emailed a student agreement, health history, waivers and other forms which must be completed and returned before the start of the camp session.

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Extreme Journey History Camp at Oatlands Registration Form

Camper/Student Information

Parent/Guardian Contact Information

Additional Authorized Guardians

Camp Sessions

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