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Summer Academy Attendee Registration Form
MIDDLE SCHOOL CAMP - Rising 6th, 7th, and 8th Graders (St. Louis Location)
Week 3 - July 22-26, 2024, 9am to 3pm
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Denotes Required Field
Please select a camp:
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Summer Racers
– Want to know how a real race team works? Our summer racers will build their own car, practice team building skills, and learn about automotive careers. Students will learn how a go-kart works, how to use tools, how pit stops win a race, and how to drive a real go-kart safely!
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First Name
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Last Name
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Gender
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Male
Female
Ethnicity
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Black
White
Hispanic
Asian
Pacific Islander
Other
Date of Birth
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+
Allergies/Disabilities. Does your child have a disability or impairment that requires accommodations or modifications in the design of the physical, curricular or social environment, i.e. access ramps, adjustable seating or interpreters?
School & school district
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Grade student is entering Fall 2024
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6
7
8
T-Shirt Size
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Adult small
Adult medium
Adult large
Adult XL
Adult XXL
Parent/guardian first name
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Parent/guardian last name
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Email Address
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Address
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City
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State
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Zip
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Primary Phone
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Secondary Phone
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Emergency contact first name
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Emergency contact last name
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Emergency contact primary phone
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Emergency contact secondary phone
Authorized to pick up #1 (other than self) full name
Authorized to pick up #1 phone number
Authorized to pick up #1 relationship to child
Authorized to pick up #2 (other than self) full name
Authorized to pick up #2 phone number
Authorized to pick up #2 relationship to child
Authorized to pick up #3 full name
Authorized to pick up #3 phone number
Authorized to pick up #3 relationship to child
Other authorized pick up
Assumption of Risk Form
I have read and agree to the Assumption of Risk Form (link to pdf above)
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Yes
Coupon Code