2019/2020 Winter Camp Scholarship Application

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WINTER CAMP (Grades 2 - 8)
*Scholarship Application*

Hours: 9:00am - 4:00pm
Scholarship Fee: $10 for one camp selection, $15 for two camp selections

Maximum of two (2) scholarships per family. Scholarships are NOT guaranteed.

MON/December 30
Grades 2 - 3: Winter Animals
Grades 4 - 6: Arctic Adventures
Grades 7 - 8: Winter Storm Chasers

THU/January 2
Grades 2 - 3: Blizzard Wizards
Grades 4 - 6: All About Snow
Grades 7 - 8: Ice Exploration

FRI/January 3
Grades 2 - 3: North Pole Explorer
Grades 4 - 6: Cryptobiology: Mythical Creatures
Grades 7 - 8: Astrobiology

Scholarship application closes on Monday, December 16, 2019 at 12:00PM. Applicants will be notified of their status by Tuesday, December 17, 2019.
PARENT/GUARDIAN INFORMATION












This program is located in San Diego, CA ONLY
SCHOLARSHIP APPLICATION


My household income is $
per year.
All applicants will be notified of their status by Tuesday, December 17, 2019.

If you qualify for the scholarship, you will receive an email to let you know and your student(s) will automatically be register for the camp. You do not need to do anything else!

If you do not qualify for the scholarship, we will refund the scholarship application fee and you can register online at the full price.
STUDENTS

STUDENT 1



MM/DD/YYYY











Subtotal: $
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STUDENT 2



MM/DD/YYYY







Subtotal $:
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AUTHORIZED ADULTS FOR PICK-UPS
Please provide the authorized adult(s) first name, last name, and phone number.






TEMPORARY MEDICAL AUTHORIZATION
By enrolling my child(ren) to attend Winter Camp at the Elementary Institute of Science (EIS), I, the parent/guardian, give EIS permission to act on my behalf in case of a medical emergency for my child(ren) while participating in the program.
EMERGENCY CONTACTS






MEDICAL INFORMATION





 
WINTER CAMP SUBTOTAL
$
TOTAL PRICE
$
IMPORTANT PROGRAM INFORMATION
Changing Sessions after Registering
If there is space available, there will be a change fee of $20 per student to accommodate this request.

Cancellation Policy
Cancellation and refund will be issued based on when EIS is notified of cancellation, prior to start date.
  • 1 month or more = Registration fee minus $20 processing fee per student per session
  • Less than 1 month prior to program start date = 50% refund
  • Less than 2 weeks prior to program start date = 25% refund
  • Less than 1 week prior to program start date = No Refund

Waiver of Liability
By enrolling my child(ren) in this program, I hereby give permission for them to participate in all the various activities, including field trips, of the Elementary Institute of Science (EIS). EIS does not assume financial or legal liability in case of injury or accident. I hereby waive all claims against the Elementary Institute of Science, its Board, employees, and volunteers for injury, accident, illness or death that may occur while participating in EIS programs.

Media Release
By enrolling my child(ren) in this program, with the Elementary Institute of Science (EIS), I, the parent/guardian, agree to authorize EIS to photograph, videotape, film, or quote my child(ren). I authorize the EIS to permit the use and the publication of any photographs, videotape, or film of my child(ren) for publicity purposes, including release of such photographs, videotape, film or quotes, to the news media and on the EIS website. I agree to hold harmless the Elementary Institute of Science, its officers, agents, and employees from any liability resulting from, or arising in connection with, the taking, publication, and release of the photographs, videotape, film or quotes of the student(s) in this agreement.
CREDIT CARD





Comments/Notes for EIS (Optional)

Please review your registration before submitting.
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Campaigns: Day Three