Howdy Camp Registration

Welcome to Howdy Camp registration! Please complete the form below to register for Howdy Camp 2010.

Basic Information

First Name: *

Middle Initial:

Last Name: *

Preferred Name:

UIN (#): *

Gender: *

Male

Female

Date of Birth: *

Over 18?: *

Yes

Mailing Address: *

City: *

State: *

Zip code: *

Home Phone: *

Cell Phone:

Preferred E-mail: *

(Your confirmation packet will be e-mailed to this address)

Health and Emergency Information

Emergency Contact Name: *

Emergency Contact Phone: *

Emergency Contact Relation: *

Health Insurance Company: *

If none, please write "None"

Health Insurance Policy Number: *

If none, please write "None"

Health Insurance Phone:

Physician Name:

Physician Phone:

Special Services or Accommodations:

Please list any special services or accommodations you may require due to an existing medical condition, physical disability, or any physical condition limiting your activities.

Medications and Dietary Restrictions:

List any medications you are taking and any dietary restrictions. (ie: vegitarian)

Allergies:

List any allergies to drugs, food, insects, plants, etc.

Do You Wear: *

Glasses

Contacts

None

Payment Information

Method of Payment: *

More information on these payment options will be shown once this form is completed.

Parking Permit: *

If you will need a parking permit for the days of camp, please select this option. A payment of $5 will be required at check-in on January 8th if you need a permit.

Important Information

Howdy Camp’s refund policy is as follows:
- Cancellation requests must be received or postmarked by Friday, January 1, 2010. Only 50% of the registration fee will be refunded.
- No refunds will be given after the Friday, January 1st deadline.
- No refunds will be given for non attendance once you are registered and confirmed.
Howdy Camp is NOT New Student Conferences. New Student Conferences is a mandatory academic orientation that is coordinated by the Department of Student Life. Howdy Camp is a student-run, extended orientation program. To register for New Student Conferences, go to http://newaggie.tamu.edu or call (979) 845-5826 between the hours of 8am-5pm CST.

I have read and understand the important information above and agree to the cancellation policy.

Initials: *