Third-Party Payer Form

This form is used to notify our Customer Relations team of a Third-Party Organization covering costs of a child’s registration. It is advised to discuss all fields below with your Third-Party Organization to ensure accurate information is listed.

Parent/guardian first name

Parent/guardian last name

Child(ren) first and last name

Parent/guardian email address

Parent/guardian phone number

Have you already registered?

Program location name (If unsure, please refer to the Program Search Page)

Third-party organization name

Third-party contact information (List any phone or email)

Do we have permission to disclose information to the third-party organization if requested?

Payment Method

Parent/Guardian will pay upfront and be reimbursed by Third-Party Organization directly later or Third-Party Organization will be paying upfront on parent/guardian’s behalf, at the time of registrationParent/Guardian will pay at the time of registration, and the Third-Party Organization will send payment directly to National Inventors Hall of Fame to be applied later. Parent/guardian will then need refunded by National Inventors Hall of FameOther

If other, please describe:

Third Party Payment Utilization Notice: As a non-profit organization, funds from registrations go directly towards camp costs such as instructor stipends, materials used, and program development. Payment is required at the time of registration, which is why it is recommended to seek reimbursement from a utilized Third-Party Organization, unless they can pay upfront on the parent/guardian’s behalf. A child’s registration at camp is not considered secured and “Active” until payment has been completed in full, whether that’s by paying in full at the time of registration or by completion of utilizing a Payment Installment Plan, with the first installment collected at the time of registration.

If payment cannot be made by either the parent/guardian or Third-Party Organization, please call the Customer Relations Department at 800-968-4332 to discuss available options. Additionally, it is the parent/guardian's responsibility to coordinate and follow-through with their Third-Party Organization to ensure payment is secured and applied.

I have read and understand