Walsenburg STEM Camp Application Form

July 14 - 18, 2025

Please Note: There is a $25 fee to help offset the cost of supplies.

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* 1. Camper Name

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* 2. Camper Age Group

12-14

15-18

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* 3. Parent/Guardian Name

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* 4. Parent/Guardian Email

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* 5. Parent/Guardian Phone

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* 6. Address

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* 7. What allergies does your camper have, if any?

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* 8. What medication does your camper need to take, and at what time, if any?

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* 9. Camper T-Shirt Size

Small

Medium

Large

Extra Large

Other (please specify)

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* 10. What school does your camper attend?

Walsenburg RE-1

LaVeta RE-2

The Gardner School

Private School

Home School

Other (please specify)

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