STEM Camp Registration 2019
SOARRR STEM Camp 2019 Registration Form - Only 1 student per form. Please fill out a form for each child attending camp.
Completed Registration with payment of $25 includes daily breakfast, lunch and t-shirt.
Registration forms are not complete unless payment is received by Gordon Cooper Technology Center's Finance Office. You may come in and pay by credit card, cash or check.
There is only a limited amount of spaces for camp each week. Once the camp is full, you will be placed on a Wait List and contacted once a space becomes available.
Email address *
Select Session *
Select Age Group (grade completed May 2019) *
Date of Birth *
Your answer
Age of Student *
Your answer
Transportation Needs *
What location for transportation pickup/drop-off? (only for bus riders)
Student Name *
Your answer
Student Address *
Your answer
Student Ethnicity
School Student Attended 2018/2019 *
T-shirt Size *
Parent/Guardian Name *
Your answer
Parent phone number *
Your answer
Parent alternate phone number *
Your answer
Emergency Contact Person #1 other than above *
Your answer
Emergency Contact #1 Relationship to Student *
Your answer
Emergency Contact #1 Phone Number *
Your answer
Emergency Contact Person #2 other than parent or Contact #1 *
Your answer
Emergency Contact Person #2 Relationship to Student *
Your answer
Emergency Contact Person #2 Phone Number *
Your answer
Other Siblings Enrolled in STEM Camp 2019 (Name/age)
Your answer
Emergency Contact Physician and number
Your answer
List Allergies
Your answer
List Medical Issues:
Your answer
List Prescription Medications Student is Taking:
Your answer
List Physical/Mental/Emotional Limitations:
Your answer
While students are on GCTC property or a school-sponsored activity offsite, all rules and regulations as listed in the student handbook (see GCTC website for copy) will be in effect, and apply to the locations visited as though they were the GCTC campus during the activity. I agree to support GCTC with these guidelines in an effort to keep students safe. *
Field Trips are an important part of our Summer Camp. I give my permission for the above-named student to participate in planned field trips. *
I understand that my registration is not considered complete until I make payment with the Finance Office at GCTC. *
I agree that GCTC shall be the owner of this material with full rights to them and that I am not to receive payment for said video/photographs and that said material will not discredit or distort my person in any way. *
I hereby give and grant to Gordon Cooper Technology Center the video/photographs that positively promotes the image and benefits of career and technology education, as well as adult training and kid's classes. *
I hereby waive any right to inspect or approve the finished video/photographs, or any finished materials, copy or other matter which may be used in conjunction with GCTC. *
I give my permission for the above-named student to receive emergency medical treatment and transportation to the nearest medical facility for injury or illness. I understand that I will be responsible for any medical costs associated with such treatment and/or transportation. *
How Did You Find Out About Our Camp?
Have You Ever Attended Our Camp Before? *
Any Additional Information I need to share about my child as it regards to camp:
Your answer
Submit
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