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STEM@theROCK Student Sign Up
Parent/Guardian and Student Sign Up
1.
Please provide the following information for the Parent/Guardian
First Name
Last Name
Phone Number
Home Address
Zip Code
Email Address
Relationship to Student
2.
Please provide the following information for the Student
First Name
Last Name
Age
Home Address
Grade Level (upcoming school year)
What school did they attend this past school year?
What school will they be attending for the upcoming school year?
Any food allergies? If so, please list them.
Any dietary preferences? (For example vegan -no dairy, no egg, vegetarian, gluten-free, etc.)
3.
Please select the dates that your child will be attending
Availability
Week 1 (June 10 - 14) 9 - 4 pm at ROCK Community Center
-- Select an option --
Yes
No
Week 2 (June 17- 21) 1-6pm at ROCK Community Center
-- Select an option --
Yes
No
Week 3 (June 24-28) 1-6pm at ROCK Community Center
-- Select an option --
Yes
No
Week 4 (July 1-5) 1-6pm at ROCK Community Center
-- Select an option --
Yes
No
Week 5 (July 8-12) 1-6pm at ROCK Community Center
-- Select an option --
Yes
No
Week 6 (July 15-19) 1-6pm at ROCK Community Center
-- Select an option --
Yes
No
4.
Check all of the dates your child(ren) can attend STEM@the ROCK for the week of June 17.
June 17
June 18
June 20
June 21
Not available this week
5.
Check all of the dates your child(ren) can attend STEM@the ROCK for the week of June 24.
June 24
June 25
June 26
June 27
June 28
Not available this week.
6.
Check all of the dates your child(ren) can attend STEM@the ROCK for the week of July 1
July 1
July 2
July 3
Not available this week.
7.
Check all of the dates your child(ren) can attend STEM@the ROCK for the week of July 8.
July 8
July 9
July 10
July 11
July 12
Not available this week.
8.
Check all of the dates your child(ren) can attend STEM@the ROCK for the week of July 15.
July 15
July 16
July 17
July 18
July 19
Not available this week.
9.
Check all of the dates your child(ren) can attend STEM@theROCK for the week of June 10th.
June 10
June 11
June 12
June 13
June 14
Not available this week