Drexel LeBow Summer Camp Registration Form
The Secret Behind the Data of TV and Movies
This is the application for TechGirlz Summer Camp taking place at Drexel LeBow College of Business from Monday, 8/5/19 through Friday, 8/9/19. The camp takes girls from ages 12-15 through the process of analyzing data from multiple sources to create a "data quilt".
There are a limited number of spots, so please carefully consider the following before completing the registration form.
The camp takes
girls between the age of 12-15
. If your daughter is not 12 by 7/1/2019, she will not be able to attend camp. Any payments made will be forfeited.
The fee for a week of camp is $250.
A non refundable deposit of $125 will be due at the time of registration and the balance is due by 4/13/2019
Please complete one form for each daughter attending
Participant's First Name
Participant's Last Name
Age (as of July 1, 2019)
Is this the participant's first TechGirlz event?
How did you hear about this camp?
Metro Kids or Parent Magazine
Please explain other
Parent First Name
Parent Last Name
What is the best phone to reach you on during camp
Second Parent/Guardian First Name
Second Parent/Guardian Last Name
Emergency Contact Information
Emergency Contact First Name
Emergency Contact Last Name
Relationship to Child
Emergency Contact's Phone Number
Primary Doctor's Name
Primary Doctor's Phone Number
Primary Insurance Provider
Does your child have any known allergies or medical conditions?
Please explain. Also list any special dietary restrictions.
Why do you want to attend our camp?
My child, whose name is listed above, has permission to participate in TechGirlz programs during the current school year.
Indemnity and Waiver of Claim:
I acknowledge that as a condition of the Student participating in any of the programs or activities, I agree to indemnify and hold harmless TechGirlz, its volunteers, and the owners of the place where the program/activity is being held, from any liability arising out of the above mentioned program or activity.
Photographic Image Use:
I do give permission for photos or videos to be posted on TechGirlz.org, approved partner websites, or for press related purposes. No last names will be used on TechGirlz website. I understand that typing my name above constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Select Payment Amount
Full Amount $250