Payne Business Bootcamp

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Student Information

Full Name of Student

Date of Birth

Mailing Address

School Currently Attending

Grade (for upcoming school year)

Food Allergies

Parent/Guardian Information

Parent/Guardian Name

Relationship to Student

Phone

Email Address

Emergency Contact Information

Emergency Contact Name

Relationship to Student

Emergency Contact Phone Number

Important Notes

- Please make sure all contact information is accurate, as we may need to reach you in case of an emergency.

- The Payne Family Foundation Summer Camp is designed to provide educational and fun experiences. We look forward to having your child join us this summer!

Parent/Guardian Signature

Clear Signature

Date

person Signature Date

Think about a person who has influenced your entrepreneurial mindset or goals. What qualities or actions of theirs do you admire, and how would you incorporate those into your own approach to starting a business?

Starting a business involves identifying opportunities and taking action. What is a business idea you are passionate about, and what initial steps would you take to turn it into reality?

If you have any questions, feel free to contact us at info@paynefamilyfoundation.

Payment Information – Refundable Deposit

To secure your spot for the Payne Family Foundation, we require a $30 refundable deposit. This deposit will be fully refunded on the last day of camp, as long as the student completes the program.

You can submit your deposit using one of the following methods:

Check or Money Order – Payable to Payne Family Foundation
- Mail to:
  2100 Travis St., Suite 800, Houston, TX 77002
- Please include the student’s name in the memo section.
Zelle Payment – Scan the QR code below or send payment to [email protected]
- Please be sure to put the students’ name in the memo so that it can be matched to their application

Important: Deposits will be refunded in the same form they were received at the end of the program.