Registration

Minds On ~ Hands On
Science

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Registration for Science Camp

Science Camps–2008

REGISTRATION FORM

Student's Name (1):______________________________________________

Student's Age: ________ Grade entering in the fall: _____

Name (2):______________________________________________

Student's Age: ________ Grade entering in the fall: _____

Address: ______________________________________________________

City: _________________________ State: ___________ Zip: ____________

Parent Names: ____________________ _________________
Phone: _______________ Work: ___________ Cell: ______________

Fax: ____________ Email: ________________________________________

Emergency Contact: ____________________ Phone #: __________________

Four Science Camps (check 1 box or all 4)

0 Week One--May 19 - 22 “Daring Detectives”

Solve a mystery using forensic chemistry and other sciences.

Choose Camp Time: ___ 9 a.m. – 12 p.m. ___ 1 p.m. – 4 p.m.

0 Week Two--May 27 - 30 “Machine Mayhem”

              Build & test simple machines that demonstrate laws of physics.
               Choose Camp Time: ___ 9 a.m. – 12 p.m. ___ 1 p.m. – 4 p.m.

0 Week Three--June 2 - 5 “Wet & Wild”

Safari through nature to discover God's creatures.

Choose CampTime: ___9 a.m. – 12 p.m. ___1p.m. – 4 p.m.

0Week Four--June 9 -12 “Rocks & Rockets”

Be a rock hound and launch a data balloon & rocket toward space.

Choose Camp Time: ___9 a.m. – 12 p.m. ___1p.m. – 4 p.m.

Sub-total $____

X # Students ______

Total $ ____

Please note: Classes will be filled on a first-come, first serve basis. Registration fees are due at the time of registration. The fee cannot be refunded after 5/15/08. Instructor may cancel classes and refund entire amount if a minimum class size of seven (7) is not met.

MAIL REGISTRATION FORM, MEDICAL WAIVER & PAYMENT TO:

Patti Jelinek

6663 Spencer Forrest Cove West

Memphis, TN 38141