STEM Infusion SUMMER CAMPS Monday , June 17 th – Friday, June 21 st

1. STEMInfusion SUMMER CAMPS Monday, June 17th – Friday, June 21st 9am – 4pm Daily* (Lunch Provided) Includes a Friday Night Showcase from 6 to 9pm (Dinner Provided for Family Members)! *Campers will stay Friday through the evening event! * Boys’ Camp @ B. Michael Caudill Middle School Camp Focus: Robotics, Stuctural Design, Team-Building and Problem-Solving. * Girls’ Camp @ Madison Middle School Camp Focus: Robotics, Environmental Issues, Alternative Energy Sources, Team-Building and Problem-Solving. Open to Any Madison County INCOMING 7th or 8th Grade Student. TO REGISTER *Complete the attached Application and send it in or mail it in to – BOYS’ CAMPGIRLS’ CAMP B. Michael Caudill Middle School Madison Middle School Attn: Mr. Marionneaux Attn: Ms. Boytek 1428 Robert Martin Bypass 101 Summit St. Richmond, KY 40475 Richmond, KY 40475 THE DEADLINE FOR REGISTERING IS JUNE 7th! For more info, call Ms. Boytek at (859) 333-5379 (for Girls’ Camp) or call Mr. Marionneauxat (859) 893-1510 (for Boys’ Camp).

2. REGISTRATION FORM STEM Infusion Summer Camps (June 17th – 21st) Camp Selection: (Check whichever one applies) ___ Girls’ @ Madison Middle School ___ Boys’ @ B. Michael Caudill Middle School Student Camper Info: Student Name: ___________________________ Birthdate: ___ /___ /______ Gender: Girl Boy (LAST) (FIRST) (MM) (DD) (YEAR) (Circle One) Fall ‘13 School: ___________________________ Grade: 7th 8th (Circle One) Contact Information: Parent/Guardian: _____________________________ Relationship: _______________________ Mailing Address: _________________________________________________________________ (ADDRESS) (CITY) (ZIP CODE) Daytime Phone #: ( ) - E-Mail Address: ______________________________ Other Information: Please make us aware of any special circumstances/medical conditions/food allergies, etc. that the Camp Coordinator / Staff should be aware of: ___________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Basic STEM Camp Rules & Expectations: 1. Students are committing to attend all 5 days of the camp for the entire time, as well as the Friday Night Dinner and Showcase/Competition. Exceptions must be made aware to the Camp Coordinator in advance!! 2. Students will act in a safe, respectable and responsible manner at all times. 2. Students will show respect for other Campers. No bullying! 3. Students will take care of any tools, equipment and materials used in the Camp. 4. Students will dress appropriately for the Camp (shorts and t-shirts are okay). 5. Students will not use cellphones during camp without permission. Other electronics are not allowed to be brought to the camp. 6. Parents will drop-off Students by 8:55am and will pick-up Students by 4:15pm each day. However, Students will remain at Camp on Friday until Dinner and the Showcase/Competition is over (around 9:00pm). At least 1 Parent/Guardian will attend the Friday night activities. 7. Parents will encourage their Students to come each day, cooperate, try hard, and have fun! Signatures: By signing below, you acknowledge that you are both aware of the basic Rules and E xpectations of the 2013 STEM Camps and that you will abide in them. Failure to do so could result in dismissal from the Camp! Student Signature: _________________________________ Date: ____________ Parent/Guardian Signature: ________________________________ Date: ____________