WRHSC Summer Camps

Select a Camp

First Name

Last Name

Preferred Name

Date of Birth

Student Phone

Student Mailing Address

City

State

Zip Code

Student Email

Parent/Guardian Full Name

Parent/Guardian Phone

Parent/Guardian Email

Is the emergency contact information the same as the parent/guardian information?

Emergency Contact Information

Emergency Contact Full Name

Emergency Contact Phone

Emergency Contact Email

Grade you are starting in Fall 2024

High School Graduation Year

High School Name

High School Location (City, State)

Middle School Name

Middle School Location (City, State)

Adult Shirt Size

Do you have any food allergies?

List Your Allergies

Please describe why you would like to attend this camp (essays should be about half a page or 250 words).

Prompt 2 is please describe a healthcare career you are interested in any why (essays should be about half a page or 250 words).

After submitting you will be sent to the payment portal. Please make sure all information is accurate before submitting. Thank you.