KU Pharmacy Summer Camp (2024) - Application

Complete the form below to register for one of the following camp offerings in 2024:

Day Camps - $75

$75 per person, per camp

Monday, June 10
Wednesday, June 12
Friday, June 14

Two-Day, Two Night Camp - $250

$250 per person

Sunday (evening), June 23 - Tuesday, June 25

Application Deadline: Friday, May 28, 2024

●  Credit card payment is due at time of application.
●  Only complete applications with successful payment will be processed.
●  Applications cannot be saved in progress and completed at a later time.

If you are not matched to a session you can attend, your application fee will be refunded.

There are errors in your form!

Please review the marked fields below.

Participant Information

Camper first name

Camper last name

Will the participant be 18 or older on June 10, 2024?

Name for camp name tag

High school attended

Provide school name, city and state (e.g., Lawrence High School, Lawrence, KS)

Grade in fall 2024

Dietary Preference

If you need to communicate other dietary preferences or allergy information please call Darlene Lantz, KU Pharmacy Summer Camp administrator, at 785-864-1696

T-shirt Size

Contact Information

Provide primary contact email, phone and address where you would like to receive all camp-related information and notifications.

Student Email

Student Phone

- -

Street Address

(e.g., 2010 Becker Drive)

City

State

Zip

Camp Type

What type of camp are you registering for?

What is the biological gender of the camper?

(Overnight camp only)

Day Camp - Camp Preferences

Day Campers Only - Please rank the following camp sessions by preference (1-3) from the dropdown list below. A minimum of two preferences are required. If you are not matched to a session you can attend, your application fee will be refunded.

Day Camp - M June 10, 2024

Day Camp - W June 12, 2024

Day Camp - F June 14, 2023

Parking

The majority of campers are dropped off for their time at camp. Please let us know if you plan to drive yourself and will require a parking pass.

Do you plan to park on campus for the duration of your camp stay?

Parent/Guardian Information

Please provide information for one parent/guardian

Parent/Guardian name

Parent/Guardian email

Parent/Guardian phone

- -

Relationship to student

Emergency Contact

Who should we contact in case of an emergency?

If other, please provide name, email, and phone for your emergency contact

Payment

Please review your application before proceeding - you cannot make changes once you select "Proceed" below.

When you select "Proceed" below, you will be taken to our online payment service. Only applications with successful payments will be considered "complete." If you cancel your transaction, your application will be incomplete and must be resubmitted.

Amount due

Questions

If you have questions regarding this application or the summer camp program, please contact us at pharmacy-camp@ku.edu or 785-864-3252.