Polymer Clay Jewelry Making, Grades 3-5 (June 15-19)

SESSION COST: $400 (See below for discount options!)

$50 Deposit due upon registration.

Please direct camp questions to Nick Pena at 901-321-3350 or npena@cbu.edu.

Camper's First Name

Preferred Name (optional)

Camper's Last Name

Camper's Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Mobile Phone

Will this Parent/Guardian serve as the Emergency Contact during this camp?

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Relationship to Participant

Authorized to Pick Up

Other than you and the emergency contact, is anyone else authorized to pick up the camper?

Yes

No

First Name

Last Name

Phone Number

Email address

Relationship to Participant

Would you like to authorize additional people to pick up your camper?

Yes

No

Please include the full name, phone number, email address, and relationship to the camper of each person authorized to pick up.

This fall, camper will be in

3rd grade

4th grade

5th grade

School Name for 2026-27 School Year

Please select any of the following that apply to the participant:

I have food allergies or dietary restrictions

I have other (non-food) allergies

I require access assistance

Please list your food allergies or dietary restrictions

Please list your non-food allergies

Please describe the access assistance you will need

Discount: A 20% discount will be given for ONE of the following criteria (select any that applies):

CBU Alumni Parent

Registered Sibling

Catholic School Student

Submit Payment

Amount Due
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Amount Due

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Balance: The balance of your registration should be paid prior to the beginning of camp.

Waiver: Watch your email for a confirmation which will include a Waiver Form to be signed and returned prior to camp's beginning.

Images: By registering for this event, you are giving permission to CBU to use photos or video footage taken at the event, including for use in future marketing materials. For questions about images, please contact CBU Marketing at (marketing@cbu.edu).