2024 Summer STEM Camp: Kansas Aerospace

To sign up: Copy and paste this form into an email and email it to indyscitech1@gmail.com

STEM CAMP: Kansas Aerospace

Summer Break

2024 ENTRY FORM

June 18^th, 19^th, 20^th

From 2:00 – 4:00 PM

PARTICIPANTS INFORMATION:

NAME: ________________________________________________ AGE:_____________________________

ADDRESS:_____________________________________

CITY: ________________________STATE: ______

PHONE:______________________________________

Students under 18: Please list below the contact name & complete mailing address:
Parent or Guardian _________________________________________________ Phone_________________
Address___________________________________City_______________________ State_______________

Entry Fees: $25.00 per student $15.00 per student with membership

We accept cash, checks, and money orders. You may now also pay by credit card by donating the entry amount on our website indyscitech.org. Make non-refundable checks or money orders payable to the Independence Science and Technology Center. Return entry forms to ISTC, 125 S. Penn. Ave., Independence, KS 67301. (Hours 1:00-5:00 Mon.-Sat.) Or email entry forms to indyscitech1@gmail.com.

Food allergies or dietary restrictions? ______________________________________

ISTC is not legally liable for injuries.

I give ISTC permission to take photos of my child for promotion of ISTC events.

Yes___ No___

Signature of Parent or Guardian _________________________________Date_______________