Falcon STEM Camps Registration Form
Once you've completed your registration here, you'll receive a confirmation email confirming your child's spot. In the event that more registrations are submitted than available spots, we will place your camper on our waitlist. Payment in full to Pfeiffer University Division of Education with "STEM Camp" in the subject line is due within two weeks of registration. Please mail to the address at the bottom of this form. We look forward to welcoming you to Falcon STEM Camps this summer!
Student Name *
Your answer
Rising Grade Fall 2020 *
Required
Please select the camp(s) that you would like to enroll your camper in. Please complete a new form for each camper. Happy planning for STEM Camp!!! :) *
Captionless Image
Required
Child's T-Shirt Size (one t-shirt per camper regardless of multiple camp attendance)
Are you interested in a possible overnight dorm/campus experience for your camper for an additional $275 a week?
Parent Email *
Your answer
Parent Full Name *
Your answer
Parent Phone # *
Your answer
Home Address
Your answer
Allergies and/or Important Medical Information
Your answer
Does your child require an epi-pen for exposure to allergen(s)? If so, list specific instructions and send your child’s epi-pen to camp, clearly labeled, with instructions from your doctor.
Your answer
Other Important Information for the Camp Director to be Aware of: Feel free to share any information that would help us to make your child's camp experience wonderful!
Your answer
Is the parent or grandparent a member of the faculty or staff at Pfeiffer University? If so, please list name and relationship (and deduct an additional $20/week from day camps).
How many years has your child attended STEM Camp at Pfeiffer?
Your answer
Emergency Contact Name and Number *
Your answer
Individuals Allowed to Pick Up Your Child
Your answer
Do you give Pfeiffer University, director Laura Lowder, and the Division of Education permission to publish photographs and video of your child and your child’s projects on promotional materials and the camp website?
Please select the boxes that are true for your registration. Use this information to calculate your total registration fees. Email laura.lowder@pfeiffer.edu with any questions.
Camp fees are non-refundable. *
Required
Lunch for Falcon STEM Campers
*Camp staff will escort campers participating in our all day camps to the campus cafeteria, or will have lunch brought in from approximately 11:30-12:30 (lunch and short outdoor break provided weather permitting).
In the event that a particular camp does not reach minimum enrollment, you will be contacted by June 1st with the option of switching to a different camp or receiving a refund. Please check the box to show your understanding of this possibility. (Note: Our camps tend to fill up very quickly so we do not anticipate this being an issue.) *
I understand that following submission of this form the full, non-refundable, payment is due within 2 weeks, or as indicated in my selection above. Please make a note to send check in Care of: Dr. Laura Lowder Pfeiffer University 48380 US HWY 52 Misenheimer, NC 28109. Please make check payable to Pfeiffer Division of Education w/ "STEM Camp" in the memo line. *
Required
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