2017 STEM in the City Summer Camp Registration

* indicates a required field.

PLEASE NOTE: THIS FORM INCLUDES FOUR SECTIONS, ALL OF WHICH MUST BE COMPLETED BEFORE SUBMISSION:

  1. 1. STEM In the City Registration
  2. 2. Student Application
  3. 3. Program Consent
  4. 4. Policies and Expectations
Please review the Camp Policies and Expectations on our website at wheelock.edu/stemcamp

Please note that if you leave this form before hitting submit, your responses will not be saved. We recommend viewing the registration packet and having your student complete the Camper Registration section ahead of time so you can cut and paste their responses into the online form.

SECTION 1: STEM IN THE CITY REGISTRATION

You will receive detailed payment instructions in your email after you submit this registration form. Payment must be received by July 1 to guarantee a spot for your child.

Student Information

Parent/Guardian Information

Emergency Contact

In the event of illness or an accident requiring medical attention, Wheelock College will call 911 first. We will then contact you at the number(s) provided above. If you child is not feeling well, we will contact you at the number(s) above. If we are unable to reach you in either instance, please provide information below on persons who can be contacted during the time your child is at Wheelock College.

Pick-up Authorization

If other than Parent/Guardian 1 and 2 above, please list the name of the person or persons who will pick up your child after each day-long session.

Additional Information

SECTION 2: STUDENT APPLICATION

Please have the camper complete this section.

SECTION 3: PROGRAM CONSENT

SECTION 4: POLICIES AND EXPECTATIONS

Please review the policies at wheelock.edu/stemcamp before checking this box.

We respect and safeguard your privacy. This form is secure.

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