Summer Science and Engineering Camps 2018
We have three sessions for 2 age groups (June 12-14; June 19-21; June 26-28) and a late summer camp for one age group from Aug. 28-30. Please register one child per form, for as many camps as you like.
Student Name *
Your answer
Your child is:
T-W-Th, June 12 - 14: select a camp
Sessions meet from 9:00 am - 4:00 pm. GLRC is the Great Lakes Research Center on Michigan Tech's campus. Nara is the Nara Nature Center located on US-41 just south of Houghton.
T-W-Th, June 19 - 21: select a camp
Sessions meet from 9:00 am - 4:00 pm. GLRC is the Great Lakes Research Center on Michigan Tech's campus. Nara is the Nara Nature Center located on US-41 just south of Houghton.
T-W-Th, June 26 - 28: select a camp
Sessions meet from 9:00 am - 4:00 pm. GLRC is the Great Lakes Research Center on Michigan Tech's campus. .
End of Summer Camp - T-W-Th, August 28 - 30
Topic: Science & Engineering Sessions meet from 9:00 am - 4:00 pm. at the Nara Nature Center located on US-41, just south of Houghton.
Parent/Guardian Name *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Phone Number *
Your answer
Which school does your child attend? *
Your answer
What grade will your child be entering in the fall? *
Required
Address *
Your answer
Is this your child's first time attending a Center for Science and Environmental Outreach program through Michigan Tech?
Person(s) authorized to pick up your child/Emergency contact *
Please list all people who may potentially pick up your child along with their phone number and relationship to the student.
Your answer
Please list any medical conditions along with medications associated with your child (bee/peanut/shellfish allergies, asthma, diabetes, etc.). *
If your child has an inhaler, epi-pen, or insulin injections, please specify.
Your answer
Does the Center for Science and Environmental Outreach and Michigan Tech have permission to use photos of your child in educational or promotional materials? *
Please read the following liability release and parental consent and type your name in the box provided below. *
LIABILITY RELEASE AND PARENTAL CONSENT ~ Students (or their parents, if a minor) participating in programs offered through Michigan Tech (“the University”) and coordinated by the Michigan Tech Center for Science & Environmental Outreach (“the Center”) must sign and submit this LIABILITY RELEASE AND PARENTAL CONSENT form. Participants will engage in a variety of educational programs led by Michigan Tech faculty, staff and students, and invited community educators/specialists, that may be held at the Great Lakes Research Center, on Michigan Tech's Campus, aboard the Agassiz research vessel, at the Nara Nature Center, or at the Marsin Center, and/or on field trips. Consent, Waiver, Release and Assumption of Risk. I, the undersigned participant, or parent or guardian of a minor participant, understand that there are inherent risks associated with this activity that cannot be eliminated, and that each participant must assume the risk of injury or disabilities that could result. I hereby acknowledge that I am aware of these risks and I agree that I will, or if signing as a parent or guardian, to, follow all safety instructions and ask questions if I or they do not understand. In consideration of the acceptance of myself or the minor as a participant in the Michigan program, I assume the risk of and full responsibility for any bodily injuries, death, damages or expenses to me or the minor for whom I am signing which may occur in the course of or as a result of my or their participation. I do hereby fully and forever release and discharge, covenant not to sue and agree to indemnify and hold harmless Michigan Technological University and its Board of Trustees, employees, and agents from and against any and all claims, demands, damages or rights of action due to bodily injury, death, or property damage, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my participation or the minor’s participation in the Michigan Tech program and all related activities and tours. I hereby further consent to and authorize the University, Center staff or program leader(s) to obtain whatever medical treatment and/or care is deemed necessary by such staff for the health and well-being of myself or the participant during the term of program participation, including the consent to obtain and have administered any emergency medical or surgical treatment that may be required during my participation, or the minor’s participation in the program with the understanding that the cost of any such treatment will be my responsibility.Michigan Technological University reserves the right to use any pictures taken during the program for advertising and/or instructional purposes. I have read the foregoing, explained its meaning to my child or ward if the participant is a minor, and hereby do approve and consent to the terms and conditions stated. If the participant is a minor I consent to the participation of my child in the Michigan Tech program, transportation in Michigan Tech vans, as needed, and all related activities and tours. In lieu of the signature of a Parent/Guardian, please type your name in the box provided below. Thank you.
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