Student First Name *

Student Last Name *

Email *

I would like my fun kits sent to my address provided in the camp registration *
Yes
No

Address 1

Address 2

City

State/Province
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip/Postal

Preferring Virtual Meeting Time
During the day
After school
Evening
Not listed Please specify a value for Preferring Virtual Meeting Time

My student needs a device in order to participate in the virtual sessions.
No
Yes

I agree to participate in this extended learning opportunity at no cost to me and will make an honest effort to meet the following expectations:

• Attend 3 virtual sessions
  •  If my camper is not able to attend any of the three online sessions, I will submit a photo of the lab in lieu of attendance.
• Complete the end of session evaluation
• Attend the November 5th Family Fun Event on campus @ GVSU