JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Science Summer Camp - Application for Registration
To apply please answer the following questions. You can use one application for all siblings.
For more info
on the program
click here
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student(s) Full Name(s).
*
Your answer
What Grade(s)
*
Your answer
What school is / are the student(s) currently attending? --- AND --- What is / are the Student(s) interest? (Example: Morikami Park Elementary and likes Playing with Legos)
*
Your answer
Mother's First and Last Name:
*
Your answer
Father's First and Last Name:
*
Your answer
Mother's mobile Phone:
*
Your answer
Father's mobile Phone:
*
Your answer
Mother's Email Address. (If not applicable use "
NA@gmail.com
") Please provide a good email address. We will be sending you important documents. NOTE: Hotmail email accounts don't work well.
*
Your answer
Father's Email Address. (If not applicable use "
NA@gmail.com
") Please provide a good email address. We will be sending you important documents. NOTE: Hotmail email accounts don't work well.
*
Your answer
Please tell us how you heard about our Program: ...
*
Flyer
Friend
Google Search
Facebook
Instagram
Twitter
Event
Other:
Required
Please tell us how you would like to pay.
*
Credit Card
Debit Card
Im using Financial Aid
Approved Sponsorship
Do you require a Payment Plan or Financing?
Yes
No
Clear selection
Which Location are you applying for?
*
Don Estridge High-Tech Middle School (For 6th. grade to 8th. grade) NOTE: REGISTRATION PERIOD CLOSED!
Morikami Park Elementary (For K through 5th. grade)
PC Professor - Microsoft Image Academy - WPB (For 5 through 7th. grade)
PC Professor - Microsoft Image Academy - Boca (For 5 through 7th. grade)
Other:
2024 Science Summer Camp - "Weeks Selection" - Please remember, there is a 2 week minimum.
*
(1) June 03rd. to June 07th.
(2) June 10th. to June 14th.
(3) June 17th. to June 21st.
(4) June 24th. to June 28th.
Click here to go on the "WAIT LIST" for full week(s).
Click here if you need the extended hour (Till 5pm - $75.00 per week)
Required
Discounts - (Select the discounts that you are applying for.)
Early Registration Discount (Deadline for this discount is April 30th.)
Sibling Discount
Friends Discount
For "Friends Discount", type the name of your "STUDENT FRIEND" that is joining you at Camp
Your answer
Will someone else (other than the parents) pick up the student(s)?
*
Yes
No
If yes, please provide the individual's first name, last name and relationship.
**Please Note we will need to see their Driver's License / ID when picking up students.
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
