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Kinetic Minds Inc.
Application for FREE STEAM Camp
Rising 1st - 4th graders
August 3-6, 2026
9 a.m.-2 p.m.

Camp Location
St. James AME Zion Church
205 S. George Street
Goldsboro, NC 27530
1.Type in parent's first and last full name. (no intials)(Required.)
2.Parent's current mobile phone number (must be able to receive texts)(Required.)
3.Parent's current personal email (no work emails)(Required.)
4.List the school your child attended during the 2025-26 school year. (no initials)(Required.)
5.List the grade your child completed during the 2025-26 school year.(Required.)
6.Tell us, in your own words, why you believe your child would be a great selection for the STEAM (Science, Technology, Engineering, Art & Math) camp. (No AI generated responses)(Required.)
7.I plan for my child to attend at least 3 of the 4 days of the STEAM summer camp in August. I understand that if my child misses 2 or more days of the camp, they may be withdrawn and ineligible for future Kinetic Minds camps.(Required.)
8.As the parent, I understand that my child's participation in this camp also depends on their behavior and being able to follow the instructions of the Director, staff, and adults at the camp in a respectful manner. I also understand that disruptive and disrespectful behavior demonstrated by my child towards adults or other children will not be tolerated.(Required.)
9.Do you know of anything or any issue that would prevent your child from fully participating in the hands-on activities and projects of the STEAM camp?(Required.)
10.If my child is accepted as a STEAM camp participant, I will be required to provide the following:

1) my child's medical information, including a list of their medications and allergies, if any.
2) my child's authorized pickup list.(Required.)
Current Progress,
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