Free STEM Summer Camp 2025

Student Section
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Name:

Email:

Phone:

Age:

Grade:
—Please choose an option—56789101112

Male/Female:
—Please choose an option—MF

School:

Can You Commit To The Full 6 Week Summer Camp?
—Please choose an option—YN

Career Goal (Doctor, Engineer, Bio-Medical, etc.)?

Food Allergies:

Why Would You Like To Attend The Camp?

Can You and a Parent Be on a Conference Call on June 26th From 6 pm to 7:30 pm?
—Please choose an option—YN

Can You Fill Out The Application by June 20th To Be Accepted To The Camp?
—Please choose an option—YN

I confirm that I consent, or if under age 13 I have my parents consent, to the processing of my personal data for the purpose of this form in accordance with the Patriots Privacy Policy. You also acknowledge that you may be contacted about Patriots programs and events. You may unsubscribe at any time by using the unsubscribe link found at the bottom of all of our emails.

Parent Section
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Name:

Email:

Phone:

Sign Here (Type full name):

I give permission for the named student above to participate in the Patriots STEM Summer Camp and use of the student's likeness or images in promotional material.