WCA Summer 2021 STEM Camp(s) Registration

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Please complete the following form and submit. To finalize your registration, please drop off a check or cash for the entire camp amount in an envelope to the attention of Joel Steindel: STEM Summer Camp to the Main Academy Office by April 16, 2021.

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電子郵件 *

Camper Name (First & Last Name) *

Which camp(s) will you be attending? NOTE: If campers plan to attend two camps during the same week, the discounted price to attend both camps is $179) *

(FULL / CLOSED Effective 3/15/21) Secret Agent Camp, 6/14 – 6/17/21 (M-Th) from 9am-12pm

(FULL / CLOSED Effective 3/15/21) (Science Madness Camp, 6/14 – 6/17/21 (M-Th) from 1pm-4pm

(FULL / CLOSED Effective 4/5/21) Moving Motion Camp, 7/12 – 7/15/21 (M-Th) from 9am-12pm

(FULL / CLOSED Effective 4/5/21) Wild Science Camp, 7/12 – 7/15/21 (M-Th) from 1pm-4pm

必填

Camper Grade *

Rising 2nd

Rising 3rd

Rising 4th

Risting 5th

必填

My Camper Attends *

Wesleyan Christian Academy

Another school ___________________________________________________________________________

Emergency Contact Name (First and Last) *

Emergency Contact Phone / Email

Allergies or other Medical Conditions?

Primary Parent Name? (First and Last Name) *

Primary Parent Phone Number *

Primary Parent Email Address *

Secondary Parent/Contact (First and Last Name)

Secondary Parent/Contact Phone Number

Secondary Parent/Contact Email Address

Individual(s) with permission to pick up my child from camp *

I heard about Wesleyan's Summer STEM Camp from: *

Family / Friend

Wesleyan Teacher / Parent Communications

Social Media

Google Search

Return Camper

必填

系統會透過電子郵件將你的作答內容複本傳送到你所提供的地址。

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