STEAM Camp Sign up
Event Timing: Week of June 15-19th, Monday-Friday
Event Address: Robots on Roscoe, 2139 W. Roscoe #1W
Contact us at: anna.e.jablonski@gmail.com
Parent Full Name *
Your answer
Email *
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Phone Number (Mobile) *
Your answer
Child 1: Name and birthdate *
Your answer
Child 1: Grade in Fall 2020 *
Child 1 Days Attending *
Required
Child 2: Name and birthdate
Your answer
Child 2: Grade in Fall 2020
Child 2 Days Attending
I'm interested in before-care (8-9am) or after-care (2-4pm) for $12 per hour. Please email Anna to arrange for this. *
Required
Any allergies? *
Your answer
Emergency Contact: Name and Relationship to child *
Your answer
Emergency Contact: Phone/Text number *
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If someone other than parent or emergency contact will pick your child up: please give name and number here:
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I will pay by check or Chase Quickpay / Zelle before camp begins; we will email you shortly with your amount owed. Thank you! *
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