2022 CAMP REGISTRATION – Expanding Boundaries International

STEAM Exchange Camp Registration

STEAM Exchange Camp Registration

Parent/Guardian Information

Name *

First

Last Name *

Last

Email

Phone

Address

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Country

Country

Address

Child Information

Name *

Last *

Student Email to join google classroom

Date of Birth

Grade/Class Level

Name of School

Gender *

Male

Female

Other

Prefer not to say

Allergies? *

Yes

No

Describe Allergies

Add Child Remove

Emergency Contact

Name

First

Last Name *

Last

Phone Number

STEAM Exchange Fees

Camp Fees: $100.00

Number of Students

Total

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