WRT "Walt's Imagination Station" 2024 Summer Camp Student Application for June 3-6

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

WRT "Walt's Imagination Station" 2024 Summer Camp Student Application for June 3-6

Thank you for submitting a student application to attend one of the 2024 Walton Robotics Summer Camps held on the Walton HS Campus from June 3-6. We are looking forward to introducing your student to some of our favorite things which includes robotics, engineering, programming, problem-solving and fun!

The Morning Camp Session for Rising 6-9th Graders will be held from 9:00 am-12:30 pm.

The Afternoon Camp Session for Rising 3-5th Graders will be held from 1:00 pm-4:30 pm.
Note: If you are registering more than one student, please fill out a separate application for each student.

Space is limited for each camp so we can provide our campers with a hands-on learning experience in a small group setting. Submitted applicants will receive an email response with more details and a link to our Paypal payment processing portal.

The deadline for enrolling and submitting the $250 Camp Tuition payment is MAY 24th, 2024. Please note that enrollment in the camp is not complete until payment is received, and tuition payments are non-refundable.

Email *

Student's First and Last Name *

Are you registering this student for the Morning Session (Rising 6-9th Grade) or Afternoon Session (Rising 3-5th Grade) for the Walton Robotics Summer Camp? *

Morning Session

Afternoon Session

School Attending for 2024-2025 *

Grade Level (2024-2025 school year): *

Please list any allergies and/or dietary restrictions: *

If none, type "none" in the text box.

Please list any medical conditions that we should be aware of: *

If none, type "none" in the text box.

Is your student currently a member of a robotics team at their school? *

Yes

Is your student interested in being part of a robotics team at their school next year? *

Parent First and Last Name *

Parent Contact Email

All camp related correspondence will be sent to the email address submitted. Please make sure your email is entered correctly. Also, please check your spam folder if you have not received an email from Walton Robotics confirming your registration within 2 business days.

Parent Cell Phone Number *

This is the primary number we'll use to contact you if we need to communicate with you while your student is attending the camp.

Parent Alternate Phone Number *

This is the alternate number we'll use to contact you if we cannot reach you at the primary number.

Cobb County SD Release and Liability Waiver:

Do you agree to the following Cobb County School District Blanket Release and Liability Waiver for your child's participation in the Forensics Workshop? Please note, this waiver is a requirement for participation in events held on CCSD property.

CONSENT FOR MEDICAL TREATMENT

I hereby consent for my child to participate in WHS Robotics school/community events and field trips. I understand that transportation may or may not be provided by the Cobb County School District. In the event transportation is not provided by Cobb County School District, transportation will be the student’s responsibility.

If any emergency medical procedures or treatment are required by the student during the event or trip, I consent to the event or trip supervisor(s) taking, arranging for, and consenting to the procedures or treatment in his/her discretion.

WAIVER AND RELEASE

I release and waive, and further agree to indemnify, hold harmless or reimburse the Cobb County Schools District, the Board of Education, its successors and assigns, its members, agents, employees, and representatives thereof, as well as event/trip supervisors, from and against, any claim which I, any other parent or guardian, any sibling, the student, or any other person, firm or corporation may have or claim to have, known or unknown, directly or indirectly, from any losses, damages or injuries arising out of, during or in connection with the student’s participation in the activity, any trip associated with the activity or the rendering of emergency medical procedures or treatment, if any.

I agree

Walton Robotics Parent Agreement Statement

Please indicate you accept the following statements by checking each box.

I understand that the Walton Robotics Summer Camp will be held on the Walton HS Campus under the direction of Cobb County School personnel, with the assistance of Parent Volunteers. Our WHSR team members act as camp counselors and lead instruction and camp activities. Students work in small groups of 3-4 campers in addition to participating in some large group activities. As appropriate, safety googles may be provided to students to wear as a part of a robotic activity. Closed-toed shoes are required.

I agree that my student may be dropped off through the carpool line up to 15 minutes before the beginning of their camp each day at the front entrance of the school. Students must be picked up promptly at the end of their camp (12:30 or 4:30, respectively) each afternoon at the front entrance of the school.

A welcome letter and link to an on-line payment site will be emailed to the parent's email address above. Payment is required to complete camp registration.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Walton Robotics. Report Abuse

Forms