Summer Session Registration Page 1

Student Name * First Last
Student Gender *
Student Date of Birth * MM / DD / YYYY
Permanent Home Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number ### - ### - ####
Parent/Guardian 1 *
Name Age Relationship to child Occupation Employer Cell - - Email
Parent/Guardian 2
Name Age Relationship to child Occupation Employer Cell - - Email
To help us provide optimum diversity in the League, please indicate your child's ethnic background (response is optional)
Language(s) spoken at home
Has your child had any experience with Model United Nations in the past? If so, where and when?
Reasons for applying to the League of Creative Minds, Summer camps
School *
Grade (2021-2022) *
Name of Camp *
Camp Date(s)*
Camp Type*
Do Not Fill This Out