Camp Health & Wellness Registration

Thank you for your interest in Camp Health & Wellness. Complete the information below to register for this year's camp. Registration form must be received by June 9, 2023.

Please complete form for each participant. Transportation to camp is your responsibility. Lunch will be provided daily.

Please mail a check or money order for the $20 non-refundable fee with the name of the participant. Make checks payable to Delta College Camp Health & Wellness. Mail to Delta College Camp Health & Wellness, Attn: Kara Jimenez, 1961 Delta Road P165, University Center, MI 48710.

For more information contact Kara Jimenez at 989-686-9286 or karajimenez@delta.edu.

If you see this don't fill out this input box.

*First name

*Last name

*Address

*City

*State

*Zip code

*Phone

*Emergency phone

*High school

*Entering grade (Fall 2023)

*Parent/guardian name

*Parent's email address

*T-shirt size

Please Select S M L XL XXL

Choose Your Sessions

You will be able to attend eight sessions during the camp. Please select the ones you are interested in and rank them from one to eight in order of preference, one being of highest interest and eight being the lowest. We will make every effort to match your sessions to your choices.

Athletic Trainer

Please Select 1 2 3 4 5 6 7 8 Not preferred

Chiropractor

Please Select 1 2 3 4 5 6 7 8 Not preferred

Dental Hygiene/Dental Assistant

Please Select 1 2 3 4 5 6 7 8 Not preferred

Dietician

Please Select 1 2 3 4 5 6 7 8 Not preferred

Emergency Medical Technician

Please Select 1 2 3 4 5 6 7 8 Not preferred

Health Fitness Specialist/Personal Trainer

Please Select 1 2 3 4 5 6 7 8 Not preferred

Laboratory Medical Technician

Please Select 1 2 3 4 5 6 7 8 Not preferred

Medical Assistant

Please Select 1 2 3 4 5 6 7 8 Not preferred

Mental Health Professional

Please Select 1 2 3 4 5 6 7 8 Not preferred

Nurse Practitioner

Please Select 1 2 3 4 5 6 7 8 Not preferred

Nursing RN/LPN

Please Select 1 2 3 4 5 6 7 8 Not preferred

Occupational Therapy

Please Select 1 2 3 4 5 6 7 8 Not preferred

Pharmacy

Please Select 1 2 3 4 5 6 7 8 Not preferred

Phlebotomy Technician

Please Select 1 2 3 4 5 6 7 8 Not preferred

Physical Therapist/Physical Therapist Assistant

Please Select 1 2 3 4 5 6 7 8 Not preferred

Physician

Please Select 1 2 3 4 5 6 7 8 Not preferred

Physician Assistant

Please Select 1 2 3 4 5 6 7 8 9 Not preferred

Radiography

Please Select 1 2 3 4 5 6 7 8 Not preferred

Respiratory Care

Please Select 1 2 3 4 5 6 7 8 Not preferred

Sonography

Please Select 1 2 3 4 5 6 7 8 Not preferred

Speech Language Pathology

Please Select 1 2 3 4 5 6 7 8 Not preferred

Surgical Technology

Please Select 1 2 3 4 5 6 7 8 Not preferred

Have you previously attended Camp Health & Wellness?

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