YDP Enrollment and Payment Form

Young Diplomats Program Enrollment and Payment Form
Ready to embark on the adventure of a lifetime? Join Hampton University's Young Diplomats Summer Program, where rising high school students dive into fascinating tracks like African Language and Culture, Leadership Development, and Global Affairs while staying on our stunning waterfront campus.

Between mastering diplomacy skills and exploring humanitarian issues, you'll get to unwind with thrilling activities like horseback riding and sailing, making this summer an unforgettable blend of learning and excitement!

Event Dates: June 21 - 27, 2026
Let's Get Started!
All registration closes by 11:59 P.M. EST on Friday, April 17th, 2026 or when our 120 participant cap is met, whichever occurs first!

Full payment is expected at the time of registration.

Participant/Student Information
Participant Name*

First NameLast Name
Street Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is the Mailing Address the same as Street Address?

YesNo
Mailing Address (If Different)*

Street Address

Street Address Line 2

CityState

Zip Code
Student's Phone Number
Please enter a valid phone number.
Student's Birthday*
High School
Student's Email*
example@example.com
Student's Gender
High School GPA*
Roommate Preference
Parent/Guardian Information
Parent/Guardian Name*
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Work Phone Number
Please enter a valid phone number.
Parent/Guardian E-Mail Address*
example@example.com
Emergency Contact Name*
Emergency Contact Phone Number*
Please enter a valid phone number.
Recreational Activities and Academic Track

Select preferences for the participant/student.
Drag and drop the activities below to select your choice for recreation in rank order of preference (1-8)*
Maximum of 10 Participants per instructor.

(Please be aware that activities are on a first come, first served basis provided enrollment is complete to include full payment and the medical form.)

Activities above are subject to change.
Drag and drop the options below to select your academic track in rank order of preference (1-7)*
(Please be aware that activities are on a first come, first served basis provided enrollment is complete to include full payment and the medical form.)

Activities above are subject to change.
Shirt Option

One (1) YDP polo shirt is included with your registration. Select your participant's preferred shirt size.
Polo Shirt Size (included with registration)
Shirt Size (included with registration)

Enrollment Payment Details
Payment Options:

The $1,700 early enrollment fee must be paid in full by March 2, 2026 by 11:59pm EST. If not paid in full, the enrollment fee increases to $1,900.

Enrollment deadline is April 17th, 2026 by 11:59pm EST.

You may pay online or over the phone using a credit/debit card by calling the Cashier’s Office at 757-727-5663. Please let the Cashier know the name of the participant(s) and that you are paying for the Young Diplomats Program.

Enrollment fee must be paid in full to hold the participant’s registration. No payment plans will be offered.

All payments made to the Young Diplomats Program are NON-REFUNDABLE.
Current Date and Time (used in calculations. do not edit/remove.)

MonthDayYear
Date
Hour MinutesAM/PM Option
Registration Fee (used in calculations. do not edit/remove.)

Payment Amount*

USD

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

MEDICAL CONSENT FORM

Young Diplomats Summer Residential Program
Participant/Student Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Current date for calculations

MonthDayYear
Date
Participant/Student Date of Birth*

MonthDayYear
Date
Age
Age OLD DO NOT USE
Does your child have ANY medical problems that we should now about (for example: allergy to drugs, physical handicaps, etc.)? Please specify:
Should there be any limits on his/her activities? If so, please explain:
At the present time, is he/she under medical care? If yes, please explain below and provide your child's doctor's information.*

YesNo
If yes, please explain?
Doctor's name

First NameLast Name
Doctor's address

Street Address

Street Address Line 2

CityState

Zip Code
In case of an emergency, please provide the following information:
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone #*
Please enter a valid phone number.
Emergency Contact Address*

Street Address

Street Address Line 2

CityState

Zip Code
Is the student covered by medical insurance?*

YesNo
I do hereby authorize the performance of medical examinations and necessary treatments (including tests, X-rays, drugs, etc.) as may be deemed necessary by the physician in attendance. This consent shall be in effect for the period of time that my son/daughter is enrolled as a student in the Young Diplomats Summer Residential Program (YDP). If an emergency arises requiring a major surgical procedure, the program staff will attempt to reach me and to be guided by my wishes. If I cannot be reached, I authorize the attending physician to act as medical judgment may dictate. I also understand that YDP staff are not to administer any over the counter medications.
Parent/ Guardian Signature*

Clear
Signing Date*

MonthDayYear

Photo Release Form

Hampton University
Hampton University is dedicated to academic excellence and providing a safe environment for faculty, students, staff and all guests of the university. In support of this mission, Hampton University may videotape, record, and/or photograph students and teachers in classroom settings, as well as speakers at functions, workshops and seminars. Hampton University may also record people during interview, and use their images, audio, and written comments.

By signing, you agree to permit Hampton University to photograph, film or tape you, and record your voice. You further give the Hampton University its assignees an irrevocable, non-exclusive, royalty-free right to use:

All or any part of the films, tapes, and digital or audio recordings of you, as they may be edited.

Your name and photograph in the video/presentation as it may be shown throughout the world on social media, or in any other present or future media, as well as in advertising and publicity of the University.

By signing, you attest that you are at least 18 years of age, and you agree that the Hampton University’s use as described above will not violate your privacy or any other rights you may have under common law.
Participant/Student Title (IF APPLICABLE)
Participant/Student Name*

First NameLast Name
Participant/Student Signature*

Clear
Signing Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState

Zip Code
If a minor (under age 18), a parent/guardian signature is required:
Minor's Name

First NameLast Name
Parental/ Guardian Signature*

Clear

Hampton University Agreement and Release from Liability

All participants MUST fill out and submit this form
Assumption of Risk

1. I am aware that participating with Hampton University and the Young Diplomats Fitness Recreational Activity (Tennis, Golf, Horseback Riding, Sailing, Mixxed Fit, Dance, Yoga, Bowling, and Soccer) Program unavoidably exposes me to a number of hazards, circumstances, and conditions. I am voluntarily present and participating with knowledge of the danger involved and hereby agree to accept any and all risks of injury or death which may attend my presence and participation.
I verify this statement by placing my initials here: *

Clear
Release

2. In consideration of being permitted by Hampton University to enroll and participate in the Young Diplomats Fitness Recreational Activity (Tennis, Golf, Horseback Riding, Sailing, Mixxed Fit, Dance, Yoga, Bowling, and Soccer) Program. I hereby agree that I, my assignees, heirs, distributes, guardians, and legal representatives will not make a claim against, sue, or attach the property of Hampton University, or any of their principals, agents, employees, or representatives, for injury or damamges resulting from the negligence or other acts, conditions, or circumstances, however caused, by any principal, agent, employee, or representative of Hampton University, from all actions, claims, or demands that I, my assignees, heirs, distributes, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my presence at Hampton University or from mmy participation in the fitness recreational activity with Young Diplomats Program (YDP).

Knowing and Voluntary Execution

3. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and Hampton University and I sign it of my own free will.
Executed on Today's Date* , 2025.
Printed name: Name*
Participant/Releaser Signature*

Clear
Signature of Parent or Guardian of Minor*

Clear
Please verify that you are human*
Should be Empty:

Young Diplomats Program Enrollment and Payment Form

Participant/Student Information

Parent/Guardian Information

Recreational Activities and Academic Track

Shirt Option

Enrollment Payment Details

Payment Options:

MEDICAL CONSENT FORM

Photo Release Form

Dietary Needs Form

Hampton University Agreement and Release from Liability