SUSPENDED FORM

Parent / Guardian Name

Scholar Name (if registering more than one scholar, register one scholar at a time under each name)

Parent / Guardian Telephone Number

Email

Mailing Address

Does your scholar attend a Title I school? (Title I schools are schools where 40% of the student population is considered low income)

Yes No

School district attended by your scholar

If you selected "Other", please specify the school district.

Please enter the name of the school your scholar is currently attending

Grade (This event is only for 5th-8th grade scholars)

Does your scholar have any allergies we should be aware of?

Yes No

If you answered yes to the above question, list the allergies here.

Does your scholar have any pre-existing medical conditions that may prevent them from viewing bright lights, flashing lights, or anything of that nature?

Yes No

Shirt size of your scholar

Is your scholar currently involved in any STEM related activities? This could include activities done outside of school. (Please provide details if possible)

What is your scholars current GPA (Grade Point Average)?