Name: 2020 Scrubs Camp – Regular Registration
Start: 2020-04-16T00:00:00+05:00
End: 2020-06-30T23:59:59+05:00

Please download the application form, fill it out, and return to bklein@hughston.com.

Note: Your registration is NOT complete until you fill out and send in the payment information below.

Participant Information
Guardian Name*
First Last
How many participants are there?*
- 1
- 2
Student Name*
First Last
Student Name #2*
First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Is this registration before April 30?*
- Yes
- No
Select Payment Option (Early Bird through April 30)*
Select Payment Option (Regular Registration April 30 – May 28)*
Note
Once you click "Send," you will be directed to a confirmation page with payment options.

Participant Information

Note