Post University Summer Academy 2026
Registration Form
My Student will attend:
*
Please Select
InvestHer Academy
Crime & Justice Academy
Esports Academy
STEAM Summit
Student's Full Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Student's Email
*
example@example.com
Parent or Guardian Name (contact person for the duration of the academy)
*
First Name
Last Name
Relationship to the student:
*
Parent
Guardian
Cell Phone Number
*
Format: (000) 000-0000.
Parent or Guardian Email
*
example@example.com
Parent or Guardian's Address if different form the student's listed above
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contacts
Please provide three contacts for us to use in the unlikely event of an emergency.
1. Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the student
Type a label
2. Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the student
3. Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the student
Medical Insurance Information
Insurance Carrier
Group/Policy #:
Provider:
Does your student have food allergies?
Yes
No
If yes, please indicate here:
Does your student need accessibility accommodations?
Yes
No
If yes, describe accessibility needs here:
Will your student be driving themselves to the academy?
*
Yes
No
Sometimes
If yes or sometimes, please indicate the make, model and year of the vehicle.
License Plate Number:
Permission form #1: Please click the link below, read and sign the forms. Use the upload button to attach the signed form.
Upload Summer Academy Release form here.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Permission forms #2: Please click the link below, read and sign the forms. Use the upload button to attach the signed form.
Upload Video, Photo and Testimonial Release Form here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Student's Signature
*
Parent's Signature
*
Submit
Should be Empty: