Nurse Camp 2025

Nurse Camp will be held July 23 through July 25. Please complete this form by July 1st.

The payment of $250 for the camp must be paid by July 1st. The payment link can be found on the Waynesburg University Nurse Camp web page.

Student Name Student Name First Last
Student Cell Phone Student Cell Phone - ### - ### ####
Student Email
Student Date of Birth Student Date of Birth / MM / DD YYYY
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Do you have any allergies (food, environmental, etc.)?
Do you have any health concerns we should be aware of (diabetic, medications needed, etc.)?
T-Shirt Size
Emergency Contact Emergency Contact First Last
Emergency Contact Relationship (Mother, Father, Grandparent, Friend, etc.)
Emergency Contact Phone Emergency Contact Phone - ### - ### ####
Is there anything else you would like us to know?
Health Insurance Card
Have you paid the $250 for the camp?
High School
When will you begin college?