Summer Academy Attendee Registration Form

MIDDLE SCHOOL CAMP - Rising 6th, 7th, and 8th Graders (Wentzville Location)
Week 1 - July 8-12, 2024, 9am to 3pm

* Denotes Required Field

Please select a camp: *

All A-Bot Robots–Robots may be the future of technology; and they are definitely fun to make and program! Students will develop their engineering and technology skills using SPIKE robots, gears, motors, and sensors while building a robot to maneuver through an obstacle course. (7 remaining)

First Name *

Last Name *

Gender *

Male

Female

Ethnicity *

Date of Birth * +

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 *

Grade student is entering Fall 2024 *

T-Shirt Size *

Parent/guardian first name *

Parent/guardian last name *

Email Address *

Address *

City *

State *

Zip *

Primary Phone *

Secondary Phone *

Emergency contact first name *

Emergency contact last name *

Emergency contact primary phone *

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) *

Yes

Coupon Code