Summer Tech Camp 2023 – Registration Form

1Student Info

2Parent/Guardian Info

3Emergency Contact

4Payment

Parent/Guardian Name(Required)

First Last

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Enter Email Confirm Email

Parent/Guardian Home Address(Required)

Street Address City State ZIP Code

Second Parent/Guardian Name

First Last

Second Parent/Guardian Phone

Second Parent/Guardian Email

Enter Email Confirm Email

Second Parent/Guardian Home Address (if different from first)

Street Address City State ZIP Code

Summer Tech Camp 2023 - Registration Form