STARBASE Fort Harrison Military Kids STEM Camp

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This is to register and grant permission for your child/dependent to attend the STARBASE STEM Camp for military kids at the Fort Harrison, MT.

This is open to youth going into grades 4, 5, and 6 in Fall of 2024.

June 10-13, 2024

9am-3pm

Youth should bring a water bottle, clothes suitable for outside activities, a midmorning snack, and a lunch.

PLEASE FILL OUT ONE FORM PER YOUTH.

Youth's Full Name *

Youth's Birthdate (MM/DD/YYYY) *

Youth's Age *

Youth's Grade Level as of Fall 2024 *

4th

5th

6th

Youth's Sex *

Mark only one oval.

Female

Male

Other:

Please select all that apply to your child:

English is the 2nd language for my child

My child's mother/father/guardian is on active duty is the U.S. Military, in the reserves, the National Guard, or is a veteran of the U.S Military

My child is part of a low income household

My child has a physical or learning disablity

My child is of Hispanic or Latino ethnicity

What is the racial identity of your child?

White

American Indian/Alaskan Native

Asian

Black or African American

Native Hawaiian/Pacific Islander

Two or more races

Clear selection

Youth's School (as of Fall 2024) *

Clear form

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