M.A.S.T. Summer Camp 2018 Registration
(Manufacturing Academy of Science & Technology)
Applying For: *
Student Name: *
Your answer
Mailing Address: *
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Grade Entering 18-19 School Year: *
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School District: *
Your answer
County of Residence: *
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Parent/Guardian Name: *
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Home Phone # *
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Parent Cell Phone #
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Work Phone #
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Emergency Contact if Parent/Guardian cannot be reached: *
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Emergency Contact Phone #: *
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Can anyone other than Parent/Guardian pick up the student? *
If yes, please list:
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Lunch will be provided. Please check one.
List any medical issues/concerns for student:
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Transportation: Please check one:
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