AMPED Summer Camp 2021
Please read the following statements before completing the form.
Students must be between the ages of 10-18 to participate
Due to Covid-19- Masks are required to be worn at all times unless students are eating.
Maximum Capacity Per Camp are: 15 Students

Summer Camp Dates:
June 21-26, 2021 (9 spots left)
July 12-17, 2021 (All spots are full.)
July 26-31, 2021 (All spots are full)


AMPED BEHAVIOR POLICY:

It is our objective to keep all of our students safe and to maintain a positive environment. We will not tolerate bullying, physical intimidation, hitting or other violent behavior. Such behavior is grounds for immediate dismissal from AMPED programs. Beyond expressions of violence, AMPED students are expected and required to comply with our behavior policies. Our rules are posted inside each AMPED facility and students must comply in order to participate in AMPED programs.

AMPED Rules:
Follow the instructions given by AMPED staff and instructors - the first-time instructions are given.
Be respectful of yourself, others and program equipment (e.g. instruments, cameras, computers, etc.).
Be responsible for your own belongings and respect the belongings of others.
Use appropriate language.
Keep your hands and feet to yourself.
Food and drink are only permitted in community rooms.
BE PRODUCTIVE AND HAVE FUN!


Clear selection
Untitled Title
6th grade
*
Unsure of the question *
05/10/2010 *
Required
The Brown School *
3512 Cotter Dr 40211 *
Does your student have any allergies, illness, disability, or other medical conditions? If yes, please detail below. *
Khalila Sharasika *
Mom 502-235-3244 *
*
502-225-4860 dads cell *
Select Summer Camp Week that your Student will like to attend: *
Required
Student #1 Major Choice *
Required
Student #2 Major Choice *
Required
Student #2 Major Choice *
Required
06/20/2021 *
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