EAKC Sci-Tech Fun & Fitness Summer Camp 2018
Please note this web form is to be used by applicants seeking a scholarship for our summer camp.
SCHOLARSHIP SLOTS WILL BE AWARDED UNTIL 5/18/18. Please note we can only offer a limited number of scholarships, and that scholarships will be awarded on a first-registered, first-awarded basis. All youth must have fully complete applications to be registered.

FULL PAY CAMPER SLOTS ARE AVAILABLE UNTIL 6/04/18, and youth may be registered here:
http://bit.ly/scitechcamp2018

All scholarship applicants must turn in additional registration forms in order for their child's registration to be complete.
The additional forms will be emailed to those who sign up here, and can also be picked up Mon-Sat at:
Brownwood Recreation Center, 602 Brownwood Avenue SE, Atlanta, GA 30316.

Please contact our office for more information at 404-627-8050.

Child Information
Child's First Name *
Your answer
Child's Last Name *
Your answer
Gender *
Date of Birth *
Your answer
School Grade Level (Fall 2018) *
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
T-Shirt Size
Parent/Guardian Information
First Name *
Your answer
Last Name *
Your answer
Home Telephone Number *
Digits only, no punctuation
Your answer
Work Telephone Number
Digits only, no punctuation
Your answer
Mobile Telephone Number
Digits only, no punctuation
Your answer
E-mail Address
Your answer
Emergency Contact Information
First Name *
Your answer
Last Name *
Your answer
Telephone Number *
Digits only, no punctuation
Your answer
Relationship to Child *
Select a Parent Orientation Date
Please select the date on which you plan to attend the mandatory summer camp parent orientation. *
Required
Weekly Camp Registration
Please check the week(s) you would like to enroll your child in camp *
Required
Are you the child's custodial parent? *
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