Summer 2020- Registration Form for VIRTUAL Summer Science Club
Summer Science Club 2020 Details:

Email Ms. Steph, mssteph@tfempowerment.org, with questions.

Who: Rising 1st through 7th Graders and Youth Interns
What: Summer Time STE(A)M Enrichment Club
When: July 6, 2020 - Aug 14, 2020
Where: Google Classroom- Virtual Camp (NO IN-PERSON CLASSES!)

Registration Fee: $1000 per Child- Scholarships Available
*Including mandatory $100 supply deposit
**Students outside of NYC: 25% distance discount
MANDATORY Parent Meeting: Monday, June 29, 2020, at 6 PM - via ZOOM

6th Annual Science Fair & Culmination Celebration: Friday, Aug 14th at 5 PM

Note: There are multiple sections of the form, please complete ALL sections.
Email address *
Full Name of YOUTH PARTICIPANT *
Current Age of Youth Participant as of July 6th, 2020 *
Date of Birth of Youth Participant *
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Grade child will enter in September 2020 *
I am registering the youth participant for: *
The youth participant is biologically *
Full Name of ADULT COMPLETING THE FORM *
Cell phone number of ADULT COMPLETING THE FORM *
Relationship to Child *
YOUTH PARTICIPANT'S Summer Address *
HOME Address of ADULT COMPLETING the form *
YOUTH PARTICIPANT'S T-shirt Size *
Emergency Contact Information- List the names and contact phone numbers of three people OTHER than yourself who are authorized to pick-up the youth participant or who can be contacted in the case of an emergency. *
How were you referred to Ms. Steph's Science Club? *
What are your child's interests? *
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