J-Camp Registration Form

Please submit a separate copy for each camper.

Camper Information

Please double check your email address. We will be sending you a release packet that includes information that you will need for J-Camp.


Roommate request, if boarding. Requests will be honored only if both campers make reciprocal requests. Two campers per room; single-room requests will be considered but not guaranteed. There will be a refundable $25 deposit for each room key due at check-in.
I would be most interested in sessions on: (Check all that Apply)
 
 
 
 
 
 

Camper Parent/Guardian Information


Adviser Information


Registration Information

Early bird rates
(Check will be postmarked by 5/11/15)
 
 

Regular Rates
(Postmarked or paid after 5/11/15)
 
 
Notes:
Advisers get 50% discount on the above.
Refunds will be given to campers who withdraw by notifying us prior to May 26, minus a $50 cancellation charge. This covers the cost of expenses we are required to pre-pay. The final registration deadline is May 26, 2015.

Financial assistance

A limited number of scholarships, worth $150 off the earlybird rate, is available for students who have financial need and are interested in J-Camp. The nomination form, found on the J-Camp page, should be filled out and returned by May 11; early applications are encouraged. Parents/legal guardians, school officials and students will be notified of the recipients by May 18. Parents/legal guardians will be expected to postmark the reduced-rate camp payment and the consent form by May 26; failure to do so will result in forfeiture of the scholarship.

Upon submission of this form, an information packet will be emailed to you. Please fill out and return the consent form along with your check. Checks should be made out to Lipscomb University.

Direct payment or questions to Dr. Jimmy McCollum, Department of Communication, Lipscomb University, One University Park Drive, Nashville, TN 37204-3951. Phone: (615) 966-5788. Fax: (615) 966-1834. E-mail: jimmy.mccollum@Lipscomb.edu.