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S.C.O.R.E.
Science Camps Offer Rewarding Experiences
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S.C.O.R.E. Application Form
Student's First Name
Student's Last Name
Guardian's Name
Mailing Address
City
Region/State/Province
Postal / Zip code
Cell Phone
Email
School Student Attends
2021-2022 Grade Level
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Contact/Emergency Phone number at camp time:
Does your child have any illness, allergies or physical disabilities that the camp staff should be made aware of?
Is your child under a doctor's care at this time?
Is your child taking any medication?
In case of a medical emergency, we will make every effort to contact the parents. If contact is not possible, do you give your permission to seek medical assistance?
Please let us know of any additional information you deem necessary. Including medications or if your child is under a doctor's care.
Photo Release
Male
Female
Check One:
*
Grades 1 & 2 (June 20, 21, 22)
Grades 3 & 4 (June 22, 23, 24)
Grade 5 & 6 (June 22, 23, 25)
T-Shirt Size
*
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Would you like to be a camp volunteer?
I understand that the staff, instructors, volunteers, and CCS Educaton Foundation are not liable for any accidents that may occur.
Submit Application & Proceed to Payment
S.C.O.R.E. Application Form
Student's First Name
Student's Last Name
Guardian's Name
Mailing Address
City
Region/State/Province
Postal / Zip code
Cell Phone
Email
School Student Attends
2021-2022 Grade Level
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Contact/Emergency Phone number at camp time:
Does your child have any illness, allergies or physical disabilities that the camp staff should be made aware of?
Is your child under a doctor's care at this time?
Is your child taking any medication?
In case of a medical emergency, we will make every effort to contact the parents. If contact is not possible, do you give your permission to seek medical assistance?
Please let us know of any additional information you deem necessary. Including medications or if your child is under a doctor's care.
Photo Release
Male
Female
Check One:
*
Grades 1 & 2 (June 20, 21, 22)
Grades 3 & 4 (June 22, 23, 24)
Grade 5 & 6 (June 22, 23, 25)
T-Shirt Size
*
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Would you like to be a camp volunteer?
I understand that the staff, instructors, volunteers, and CCS Educaton Foundation are not liable for any accidents that may occur.
Submit Application & Proceed to Payment
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