SCIENCE IN THE SUMMER AT ESPERANZA
Science in the Summer is a program sponsored by GSK and offered in collaboration with the Franklin Institute to increase children's value of and confidence in doing science. The program will allow 2nd- 6th graders to explore what it is to Be a Physicist! Offered at Esperanza College 4261 N 5th street, Philadelphia, PA from Tuesday, August 1st through Thursday August 3rd from 9:00 am to 12:00 pm. 
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Be a Physicist!
Name of parent: *
Email address: *
Home Address with Zipcode: *
Phone number: *
Name of student: *
Student's Date of Birth: *
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Gender: *
Race/Ethnicity *
What grade will the student attend in Fall 2023? *
Name of school for Fall 2023: *
Emergency Contact (name and phone number): *
Emergency Contact's Relationship with Student: *
PARENTAL CONSENT:
My signature serves as my approval for my child to participate in the Science in the Summer program at Esperanza College.  I also give my consent to obtain emergency medical and or dental care for the Student if such attention is required at any time when I am unavailable for contact at the numbers listed above.

I understand that the camp will be held onsite at Esperanza College located at 4261 N 5th street, Philadelphia, PA 19140.

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