West Hunter Street Baptist Church STEM Camp
June 10-14, 2024 | 8am-3pm 
1040 Ralph D. Abernathy Blvd. Atlanta, GA 30310 
678.824.5441 | https://whsbc.com

Welcome to The WHSBC STEM Camp! To ensure a successful summer, we would like for you to read the following guidelines before signing below: 

1. Each camper attending the STEM Camp must have a registration form on file. Families with multiple campers will need to complete a separate registration form for each camper, insuring that the information on file is current. 
2. The STEM Camp is a cost free to campers and families, with breakfast and lunch are provided. 
3. The STEM Camp hours are 8:00 am to 3:00 pm, Monday, June 10 to Friday, June 14, 2024. There is no before care or after care available, therefore campers are asked to arrive no earlier than 7:45 AM and get picked-up no later than 3:15 PM. A 15 minute grace is extended, however after 15 minutes, there will be a $1/minute per camper charge for any campers who remain. 
4. Only individuals designated on the registration form with appropriate legal photo identification will be allowed to pick up your child. For your child’s protection, campers must be signed in/out daily. 
5. To ensure the safety and security of all students in the STEM Camp, surveillance will occur during camp hours. The Atlanta Police will be contacted should an emergency occur. 
6. We expect all children to behave properly. Students may be suspended or withdrawn form the STEM Camp for the following reasons: Excessive Late Arrival/Pick-Up and/or Behavior Concerns.
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Email *
Camper's Name *
Gender *
Birth Date *
MM
/
DD
/
YYYY
Grade (2023-2024 School Year) *
Age *
Street *
City *
Zip Code *
First Guardian's Name *
Cell Number *
Work Number
Second Guardian's Name 
Cell Number
Work Number
Camper's T-shirt Size *
EMERGENCY AUTHORIZATION & WAIVER ACKNOWLEDGMENT
In case of an emergency and the guardian(s) listed above can not be reached, please call the persons listed below. All emergency numbers should be local, accessible, and include the area code. Appropriate legal photo identification is necessary at time of pick up.
First Name *
Relationship to child *
Cell Number *
Work Number
Second Name *
Relationship to child *
Cell Number *
Work Number
Doctor's Name *
Office Phone Number *
In case of an emergency, please transport my child to: [Preferred Hospital] *
No Liability Insurance Acknowledgement
I understand that I am being informed in writing by signing this acknowledgement that this facility is not licensed nor required to be licensed, by the state. STEM Camp @ WHSBC does not carry insurance sufficient to protect my child(ren) in the event of an accident, injury, etc.
By selecting yes, I acknowledge that I agree to the statement above. *
Photography Release
During the camp, pictures are taken of the children during different activities. These pictures might be published in local marketing, newspapers, publications, our website, or presentations. I give permission for my camper to have his/her picture taken, activities recorded, and or published.
By selecting yes, I acknowledge that I agree to the statement above.
*
A copy of your responses will be emailed to the address you provided.
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