Registration Form (revised)

This form will be accepted throughJune 1, 2015

Tuition for each Summer Enrichment Camp is provided through the Iredell-Statesville Schools AIG Program. There is a $15.00 non-refundable registration fee for one course and a $25.00 fee for two courses taken by the same student. Please make checks payable to Iredell-Statesville Schools. Check the programs for which you would like to register and return registration information and fee to:

AIG Summer Programs 2015

ADREducationCenter

410 Garfield Street

Statesville, NC 28677

Please note: The specified grade levels for each session refer to those assigned for the 2015-2016 school year. Only students who are currently enrolled in Iredell-Statesville Schools may register for these camps. Please print the information requested.

Student Name: ______Parent Name: ______

Grade completed June 2015: ______Current School: ______

Home Phone: ______Other Phone: ______*Email: ______

(** Confirmation for camps and all other camp communication will be done through email.)

Please note that if there are not enough students enrolled in a particular course, it may be canceled. We will notify you if that occurs. Camp registration is on first come, first served basis.

___Intro to Geocaching (Grades 5-8) Session 1

___Pre-Robotics with Lego WeDo (Grades 3-4) Session 2

___Beginning Robotics (Grades 3-8) Session 3

___Advanced Robotics (Grades 5-12) Session 4

___ Art (Grades 7-12) Session 5

___ Art (Grades 3-6) Session 6

___Theater Arts (Grades 3-8) Session 7

___Theater Arts (Grades 6-12) Session 8

___Odyssey of the Mind (Grades 3-5) Session 9

___Odyssey of the Mind (Grades 6-9) Session 10

___Intro to Chess (Grades 4-8) Session 11

___Advanced Chess (Grades 6-12) Session 12

___iMovie Film Camp (Grades 7-9) Session 13

___iMovie Film Camp (Grades 5-6) Session 14

___History’s Mysteries Camp (Grades 7-12) Session 15

___History’s Mysteries Camp (Grades 4-6) Session 16

___Beginning Coding (Elementary - Grades 3-5) Session 17

___Advanced Coding (Middle/High - Grades 6-12) Session 18

Please review the following list carefully and sign below to indicate your acceptance:

  • Parents will provide transportation.
  • Staff will be responsible for students ONLY during program times. Please drop off and pick up on time. Students must be signed in and out by the parent/guardian.
  • Photographs including my child may be used for promotional purposes.
  • If my child is registered for a morning and afternoon program at the same site, parents will provide a bagged lunch and supervision during lunch.
  • I understand if I want my child to have a snack, I must provide it.

______

Parent Signature Date