BDL

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Register for Debate Camp

Select Status and Choice

This camp is free for all BPS students and students in BDL schools.

Registrant Information

First Name

Last Name

Date of Birth

What Personal Pronouns Do You Use?

School You Will Attend in Fall 2022

Grade Next Year (2022-23)

Do You Have Any Debate Experience? If Yes, What Division?

Mobile Number

Address

City

State

Zip

Emergency Contact Info

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Contact Phone

Emergency Contact Email

Medical Information

Name of Primary Care Physician

Phone No. of Primary Care Physician

Hospital Preference

Are There Any Chronic Health Problems? Has Your Child Been Treated Recently for It? If Yes, Explain.

List Any Medications Now Being Taken for Treatment of Any Medical Problem.

Are There Any Allergies to Medications or Local Anesthesia?

Are There Any Other Allergies?

Any Other Health-Related Information Staff Should Be Aware Of?

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Consent Form and Release

(Media Consent) — I have read and agreed to the terms and conditions.

(Medical Treatment) — I have read and agreed to the terms and conditions.

Amount Due

Card information

This is a secure 256-bit SSL encrypted payment

Card Number

Expiration Date

CVV

Donor hereby approves the payment of the charitable donation and/or purchase to Boston Debate League and in the amount set forth herein.

Thank you for registering for the upcoming BDL Camp! We look forward to seeing you.