STARBASE STEM Camp - Hot Springs, MT

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This is to register and grant permission for your child/dependent to attend the STARBASE STEM Camp at the Hot Springs Elementary School cafeteria in Hot Springs, MT. This event is FREE.

This is open to youth going into grades 3-8 on Tuesday, July 9 - Wednesday, July 10, 2024 from 9am - 2 pm.

Youth should bring a water bottle and clothes suitable for outside activities. Lunch will be provided.

PLEASE FILL OUT ONE FORM PER YOUTH.

Youth's Full Name *

Youth's Birthdate *

Youth's Age *

Youth's Sex *

Female

Male

Non-Binary

Other:

Youth's Grade Level as of Fall 2024 *

3rd

4th

5th

6th

7th

8th

Please select all that apply: *

English is the 2nd language for this youth

The youth's mother/father/guardian is on active duty, in the reserves, in the National Guard, or is a veteran of the US Military.

This youth is part of a low-income household

This youth has a physical or learning disability

None of these

Required

Youth's Ethnicity *

Hispanic/Latino

Non-Hispanic/Latino

Youth's Race *

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

More than one race

Parent/Guardian's Full Name *

Parent/Guardian's Phone Number

Please write as 555-555-5555

Parent/Guardian's E-mail *

Street Address *

Mailing Address *

City *

State *

Zip Code *

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