JAM Camp Registration

JAM Camp Summer 2023

To register, complete the form below. You may pay online below OR mail a check (memo: “JAM CAMP”) to: JAM, P.O. Box 141, White River Junction, VT 05001. Payment must be received to confirm registration.

Fee assistance or full waiver is available upon request, thanks to grants from Adimab, LLC and the Laurence & Mary Rockefeller Fund. Please contact info@uvjam.org with subject “Camp assistance” to make a request.

We’re excited to see you at JAM Camp this summer!

"*" indicates required fields

Camper Information

Camper First Name*

Camper Last Name*

Nickname

Age at time of camp start*

Grade (entering)*

School (entering)

Contact & Medical Information

Camper's Summer Residence Address*

Permanent Address (if different)

Name of Primary Parent/Guardian*

First Last

Primary Parent/Guardian Email Address*

Cellphone for Primary Parent/Guardian*

Second Telephone for Primary Parent/Guardian*

Name of Secondary Parent or Guardian

First Last

Secondary Parent/Guardian Email Address

Cellphone for Secondary Parent/Guardian

Emergency Contact Name*

Emergency Contact Relation to Camper*

Emergency Contact Cellphone*

Emergency Contact Additional Phone*

Emergency Contact Email Address*

Name of Primary Medical Care Provider*

Primary Medical Care Provider Phone*

Dentist*

Dentist Phone*

Please list any allergies*

What experience (if any) does your child have in film/video production, music, visual arts, or acting/performance?

Please share anything else you'd like us to know about your child to help him/her have a positive experience at camp.

Camp Registration

Product Name

Beginner Video Camp - June 26-30

Advanced Animation Workshop July 17-July 21

Radio Stories July 10-14

Music Video Camp July 17-21

Beginner Animation July 17

2-week Film Intensive July 24-August 4

Check Out Information

Registation Fee Total

Payment Options*

Credit Card

Card Details

Cardholder Name

Consent & Release of Liability

Consent & Release of Liability*

I agree to the Consent & Release of Liability policy.

* You consent to your camper participating in all regular JAM - Junction Arts & Media (Community Access Television, Inc.) activities, on and off the Briggs Opera House and JAM space facilities, and accept the fact that some of these involve inherent risks. By permitting your child to attend and participate in Camp activities, CATV and its agents, employees, and volunteers are released from any and all claims for damage arising out of injury to your child while participating in any and all activities including, but not limited to: video production (operating cameras, sound equipment, lighting, grip gear and props), acting/performance, arts and crafts, and digital editing programs. Such activities may occur on-site or off-site in Vermont or other states.
* You consent to the use of photographs or video of your camper to be used in publications, news releases, online, and in other communications related to the mission of JAM.
* You agree to inform us if your child is enrolled in an Individualized Education Program or 504 Plan, receives other special social-emotional or behavioral support, or has any medical issue that may impact their ability to engage in the camp environment or camp community. You consent to JAM contacting you and your child’s service provider(s) and/or professional(s) to develop a plan to help your child succeed at camp.
* You understand that you are responsible for your camper’s medical expenses, including deductibles, and co-pays. You consent to emergency medical treatment for the camper if CATV, in its sole discretion, determines it to be necessary. In the event of a medical emergency, you consent to CATV contacting you and other emergency contacts whom you have provided.
* You understand that your child is required to be vaccinated according to the Federal Centers for Disease Control (CDC) immunization guidelines AND Vermont Department of Health immunization schedules. Religious or philosophical exemptions are not accepted. Medical exceptions are only allowed for conditions established by the CDC or the Advisory Committee on Immunization Practices (ACIP). The medical exception must be submitted for individual shots in a signed statement from a licensed pediatrician which states:
The physical condition or medical circumstances of the camper and which vaccines are contraindicated.
Whether the medical exception is permanent or temporary.
The expiration date, if the exception is temporary.

How did you hear about camp?*

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Junction Arts & Media (formerly CATV)

Register and pay here