UW-Green Bay Grandparents University

Please enter the grandchild's information below.  
If you are registering an additional grandchild or grandparent for the same class, fill in the second child/grandparent's information at the bottom of the page. If you are only registering one child and one grandparent, you can leave the second child/grandparent information questions blank.

If you will be registering two grandparents and two grandchildren who will be taking SEPARATE classes, please fill out only ONE grandchild's and ONE grandparent's information on this page. You will have an opportunity to come back and register the other grandchild and grandparent for the class of their choice before submitting your registration.

*By checking the Liability Signiture box you agree the undersigned does hereby agree to hold harmless and indemnify the State of Wisconsin, the Board of Regents or the University of Wisconsin System, and the University of Wisconsin-Green Bay, their officers, agents, and employees, from any and all liability, loss, damages, costs, or expenses which are sustained, incurred, or required arising out of the actions of the undersigned in the UW-Green Bay Summer Camps program.

Grandchild First Name
Grandchild Last Name
Grandchild Address
Grandchild City
Grandchild State
Grandchild ZIP
Grandchild Home Phone
Grandchild Parent Work Phone
Grandchild Parent E-mail Address
Grandchild Parent Name
Grandchild Birthdate
Grandchild Current Age
Grandchild Gender
Grandchild School Attending in Fall
Grandchild School if not listed in dropdown
Grandchild Grade Level in Fall
Grandchild T-Shirt Size
Grandchild Allergies, Health Concerns, Mobility Issues
Liability Signature*
How did you hear about our program?
Grandparent First Name
Grandparent Last Name
Grandparent Address
Grandparent City
Grandparent State
Grandparent ZIP
Grandparent Phone Number
Grandparent E-Mail
Grandparent T-Shirt Size
Grandparent License Plate Number
Grandparent Allergies/Health/Mobility Issues
Do you authorize UWGB to take photographs/video of participants?
Second Child First Name
Second Child Last Name
Second Child Address
Second Child City
Second Child State
Second Child ZIP
Second Child Parent Phone
Second Child Age
Second Child Gender
Second Child Birthdate
Second Child T-Shirt Size
Second Child Parent Name
Second Child Parent Work Phone
Second Child Parent E-Mail
Second Child School Attending in Fall
Second Child Grade in Fall
Second Child Allergies, Health Concerns, Mobility Issues
2nd Grandparent First Name
2nd Grandparent Last Name
2nd Grandparent Address
2nd Grandparent City
2nd Grandparent State
2nd Grandparent ZIP
2nd Grandparent Phone Number
2nd Grandparent E-Mail
Second Grandparent Allergy/Health/Mobility Issues
Second Grandparent T-Shirt Size
= required field

Registration Notes

= required field