Summer Academy Attendee Registration Form

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

* Denotes Required Field

Please select a camp: *

Heavy Metals–Use raw metal to create your own designs! Students will learn the fundamentals of welding from simple techniques to more complex ones. Students will design and fabricate their own metal masterpiece. (0 remaining)

Remote Control Race Engineering– Students remodel a motorsports team while working to optimize the performance of a FastTrack RC (remote control) Car through inspection and modifications. Take the challenge! (9 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

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