Summer STEM Camp

Required

Camper Information

Camper First Namerequired

Camper Last Namerequired

Camper Date of Birthrequired

Must contain a date in MM/DD/YYYY format

Addressrequired

Cityrequired

Staterequired

Ziprequired

Current Middle Schoolrequired

Grade Entering 2025-26required

5th

6th

7th

8th

Special Considerations

Medical conditions, accommodations, food allergies, concerns, etc.

Household Information

Parent/Guardian 1

First Namerequired

Last Namerequired

Email Addressrequired

Phone Number

Parent/Guardian 2

First

Last

Photo/Video ReleaserequiredI give consent for my child's image to be used in Summer Session promotions.

Yes

I give consent for my child's image to be used in Summer Session promotions.

Session SelectionDue to the nature of supplies and equipment for each camper, all registrations are non-refundable.

Session One ($500.00)

Session Two ($500.00)

Both Sessions ($950.00)

Due to the nature of supplies and equipment for each camper, all registrations are non-refundable.

Payment

Payment Information

Emailrequired

Provide an email address for the receipt.

Please select a payment typerequired

Credit Card

Billing Addressrequired

Address

City

State/Province

Country

Zip/Postal Code

Cardholder Namerequired

First

Last

Expirationrequired

Month

Year