Jenzabar University

Summer College Aspiration Program Registration

Central Maine Community College is excited that you, and your child, are interested in experiencing all that our beautiful campus has to offer this summer! Please complete the online registration form, including payment, to sign your child up for any of our summer programs.

Once the registration form is submitted you will automatically be directed to our payment portal to pay for the programs(s) in full. Electronic payment is required at the time of registration.

For questions about any of the summer programming, please contact Dave Gonyea, Director of Athletics, at, dgonyea@cmcc.edu or (207) 755-5251.

General Information

Child First Name:

Child Middle Initial:

Child Last Name:

Child Date of Birth:

Child Gender:

On track to graduate high school in:

Contact Information

Child's Mailing Address:

City:

State:

Zip Code:

Child's Cell Phone:

Child's Home Phone:

Child's Email:

Parent Information

Parent/Guardian First Name:

Parent/Guardian Last Name:

Parent/Guardian Email:

Parent/Guardian Phone:

Health Information(Enter "NONE" if the field is not applicable)

Allergies:

Medications:

List any current conditions and any recent surgeries, hospitalizations, illnesses, or injuries:

Insurance Card:
Please attached a clear PDF, JPEG, or PNG file of your insurance card.

Emergency Contact Information

First Name:

Last Name:

Primary Phone:

Relationship:

You MUST click the Add button to properly submit emergency contact information.

Hidden Candidacy Year

Program Selection

Please choose "Register" from the drop-down menu next to the programs you want to participate in. For a full list and description of program offerings, click here for our Summer Program Flyer.

Social Media Influencer ($25) – 6/27

Pre-Nursing Simulation ($35) – 7/11

RC Car Build ($75) – 7/8 PROGRAM FILLED!

Boys HS Point Guard Clinic ($35) – 7/14

Art of Expression ($FREE) – 7/8

Tabletop Game Art & Design ($35) – 7/15

Sports Visualization ($FREE) – 7/8

Girls Youth Soccer Clinic ($100) – 7/15 - 7/19

Baseball ID Clinic ($35) – 7/8 - 7/9

Science is Magic ($35) – 7/18

Esports Summer Experience ($50) – 7/8 - 7/10

Fun with Forensics ($25) – 7/18

Catapult Challenge ($75) – 7/10

Esports Summer Experience ($50) – 8/5 - 8/6

Introduction to Theater ($35) – 7/10

High School Girls Elite Soccer Training ($350) – 8/2 - 8/4, Overnight

Medical Release Statement

As the parent/guardian of the student named on the previous tab, I give permission for services and/or medical treatment at Central Maine Medical Center, St. Mary's Regional Medical Center, or other hospitals. If my child requires services such as emergency room, ambulance, or prescription medication, payment will be the responsibility of the parent/guardian.

Photography Release Statement

I hereby authorize and consent to Central Maine Community College and the Maine Community College System using any photograph(s) of my child in any publication, website, advertisement, report, or other material promoting the College of the System. I hereby waive any and all rights to inspect or approve such photograph(s), and I release the College and the System from any and all claims arising from use of the photograph(s).

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