STEM Summer Camp Registration

COST IS $200 PER STUDENT (Includes t-shirt and snacks)

Participant Name:(Required)

First Last

School Attending:

Grade for 2023-24 school year:(Required)

T-shirt Size(Required)

Name of Parent/Guardian:(Required)

First Last

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone (Home):

Phone (Cell):(Required)

Email:(Required)

Emergency Contact (other than parent):

First Last

Emergency Contact Phone:

List any allergies or medical conditions:

Summer STEM Registration Fee(Required)

Price: