ZinkerzCamp | High School Journey S'27

https://www.jotform.com/build/222294659831161#general

Camp Date

Current Date

Date

Guardian 1 Name

First NameLast Name

Guardian 1 Email

example@example.com

Guardian 1 Phone Number

Guardian 2 Name

First NameLast Name

Guardian 2 Email

example@example.com

Guardian 2 Phone Number

Student Name

First NameLast Name

Student Email

example@example.com

Student Phone Number

Gender

Graduation Date

Country

Date of Birth

MonthDayYear

Passport Copy

Headshot Photo (to be used in our camp directory)

What is your T-Shirt Size?

T-Shirt Size

No worries! You'll be able to submit your itinerary details after registering.

Arrival Info (Boston inbound only)

Arrival must be on June 21st between 10am - 8pm to ensure shuttle service from the airport or train station. If flying, you must arrive at Boston Logan Airport (BOS). If taking the train, you must arrive to Route 128 Train Station.

Airline / Train

Flight / Train Number

From

To

Flight Date & Time

Date

Hour MinutesAM/PM Option

Departure Info (Boston outbound only)

Departure must be on June 27th after 5pm or June 28th before 3pm to ensure shuttle service from the airport or train station. If flying out, you must leave from Boston Logan Airport (BOS). If taking the train, you must leave from Route 128 Train Station.

Airline / Train

Flight / Train Number

From

To

Flight Date & Time

Date

Hour MinutesAM/PM Option

Please list any special rooming requests. We will do our best to accommodate up to one roommate request but cannot make any guarantees.

Do you have any food allergies we should know about?

Please specify

Please check all conditions that apply to your student

Please specify

Download the form(s) that match your student's conditions, complete with a physician signature, and email to hello@zinkerz.com.

Allergy Action Plan Asthma Action Plan Seizure Action Plan

Diabetes Management Plan Cardiac Action Plan

I authorize Zinkerz staff to administer the following over-the-counter medications if needed: acetaminophen (Tylenol), ibuprofen (Advil/Motrin), antihistamines (Benadryl), and topical first-aid creams.

Upload Student's Medical Insurance Card with Coverage in the US (front & back)

Upload multiple files at once

ZinkerzCamp Waiver

Dormitory Waiver

Rules & Guidelines

Student Signature

Parent/Guardian Signature

In case of emergency, whom should we contact?

Name

First NameLast Name

Emergency Contact Phone

Country CodePhone Number

Relationship to Student

Do you have any other special needs, requirements or comments?

Please specify

ZinkerzCamp | High School Journey - Summer 2027

Pay in Full

$5,600.00

ZinkerzCamp | High School Journey - Summer 2027

Pay in 2 installments (Now and March '27)

$2,800.00

ZinkerzCamp | High School Journey - Summer 2027

To be used in favor of bank transfer or different payment arrangement.

$1.00

Subtotal

Tax

Total

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Date

Guardians Info

Student Info

Arrival & Departure Info

Roommate Requests

Dietary Restrictions

Medical

Waivers

Additional Information

Payment

Guardians Info

Student Info

Arrival & Departure Info

Roommate Requests

Dietary Restrictions

Medical

Waivers

Additional Information

Payment

*