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Monroe County-Middle School STEAM/Summer Camp Registration Form
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* Indicates required question
Email
*
Your email
Student Last Name
*
Your answer
Student First Name
Your answer
Student Grade Level during 2023-24 school year
*
5th
6th
7th
8th
Student Street Address
Your answer
#1 Parent/Guardian Name
*
Your answer
#1 Parent/Guardian Phone Number
*
Your answer
#2 Parent/Guardian Name
Your answer
#2 Parent/Guardian Phone Number
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
Does your student have any medical conditions or issues that our STEAM Camp staff should be aware of?
*
Your answer
Will your student need bus transportation for STEAM/Summer Camp?
*
No, I will provide transportation for my student to and from camp.
No, my student will be going to the Boys and Girls Club/Teen Center before/after camp.
Yes, my student will need Bus Transportation for camp.
If you answered yes to the previous question, what address will your student need to be picked up from?
Your answer
What address will your student need to be dropped off at?
Your answer
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