Please return all registration. materials quickly to guarantee. enrollment. Page 2 of 2. summer camp app2 2016.pdf. summ
Summer Tech Camp
Application Form Student Name: _____________________________________________ Parent(s)/Guardian Names: _____________________________________________ _____________________________________________ Current School: _____________________________________________ Call to your school to find out if transportation is available! Grade Level (as of 9/16) 7th, 8th, 9th Mailing Address: _____________________________________________ _____________________________________________ _____________________________________________ Physical Address: _____________________________________________ _____________________________________________ Parents’ email addresses: _____________________________________________ ____________________________________________ Home Telephone number: __________--___________--____________ Parent cell: __________--___________--____________ After camp my child will: take a bus / be picked up other:_______________________________ Gender: M F Date of Birth: _____/______/_______
Summer Tech Camp For students entering 7th, 8th or 9th grade
June 20 - June 24 8:45am - 12:30pm
Summer Tech Camp
Application Form IN CASE OF EMERGENCY
Summer Tech Camp! Come explore 10 exciting hands-on labs in one week! Each day students visit 2 programs with their team and eat a daily snack with teachers and counsellors. Past Programs Have Included: basic welding bat house construction composting 101 plasma cutting photoshop poster design the science of baking excavator operation solar powered derby races paper airplane aerodynamics lego robotics anatomy of the senses video production parts of an engine ipod app clinic color theory
Block I 9:00-10:30am Snack 10:30-10:45am Block II 10:45-12:20pm M-Th Depart HACTC 12:30pm Friday Depart HACTC 1:00 pm
Cost: $30.00 Make checks payable to: Hartford Area Career & Technology Center
Enrollment is Limited.
Please return all registration materials quickly to guarantee enrollment.
Contact Person: _____________________________________________ Contact Person Phone Numbers: Home: _________----_________----___________ Work: _________----_________----___________ Cell: _________----_________----___________ Does the student have allergies? Y N If yes, to what? ________________________________ Does the student require/carry an EPI pen? Y N Does the student have any chronic illness(s)? Y N If yes, please list. Does the student take medications regularly? Y N If yes, please list all medications. ** As parents/ guardians, I authorize the HACTC to have my child treated at the nearest medical facility during any emergency. Y N ** It is permissible to photograph/ videotape my son/daughter while at HACTC for any media publication. Y N Parent Signature: _____________________________________________ Date: _____/______/______ ** All information must be completed HACTC does not discriminate on the basis of race, creed, national origin, religion, sex, disability or sexual orientation.
Please Return application and fee to: Havah Walther, Outreach Coordinator HACTC 1 Gifford Road White River Junction, VT 05001 1(802)-295-8630
