Science, Technology, Engineering, Arts & Math STEAM Summer Camp 2016 Where Nature s Wisdom Powers Human Innovation Save Your Spot by Returning your Registration Form and deposit to the CSMS Office Today! Camp Directors: Melissa Dunaway (Melissa.Dunaway@austinisd.org) & Rebecca Gonzales (Rebecca.Gonzales@austinisd.org) csmssteamcamp.weebly.com Artists Alive Week 1: June 13-17, 2016 Field Trip: Texas Spirit Theatre 4D show & Bowling Explore your inner artist using different mediums & styles (studio art & theatre)! Digital Storytelling Week 2: June 20-24, 2016 Field Trip: IMAX show & Bowling Tell a story using fun forms of technology! Crafting the Mind Intro to Coding Week 3: June 27-July 1, 2016 Field Trip: Main Event Come learn the basics of beginning coding using short interactive modules! (BEGINNER LEVEL) STEAM Camp 2016 For Campers going into 3 rd -8 th Grades Tuition: $300 per week $25 Discount for Early Registration The $25 per camp early registration discount is available through April 1, 2016. Early registration discount is limited to the first 30 campers per session. Deposit Due at Registration: $100 per week Camp Hours: 8am-4:30pm Free Early Drop Off: 7:30am Free Late Pick Up: 5-5:30pm Location: Small Middle School 4801 Monterey Oaks Austin, TX 78749 512-841-6700 Mad Scientists Week 4: July 11-15, 2016 Field Trip: Mayborn Science Theatre Planetarium (Killeen, Texas) Come do fun hands-on science activities! Cougar Olympics Week 5: July 18 22, 2016 Field Trip: Austin Park n Pizza Do you like to compete on a team in fun physical and mental challenges? Want to learn more about other world cultures? Come be a Cougar Olympian in our 1 st annual Cougar Olympics!
Science, Technology, Engineering, Arts & Math (STEAM) Summer Camp 2016 Where Nature s Wisdom Powers Human Innovation Clint Small Middle School is proud to announce the 5 th year of engaging STEAM Summer Camps for students entering 3 rd -8 th grades! Week long STEAM Camps offer a fun, safe, engaging educational environment to learn, explore, build self confidence, and be creative. All fun filled STEAM sessions are led by awesome CSMS staff. Register Today! Please turn in your Registration Packet and Payment to the Small Middle School Main Office either in person or by mail. Camps will be filled first come, first serve. You will receive confirmation via email within 1 week of the camp directors receiving your registration form and payment. Address: 4801 Monterey Oaks Blvd., Austin, Texas 78749 Fax: 512-841-6703 Phone: 512-841-6700 Camp Directors: Melissa Dunaway (Melissa.Dunaway@austinisd.org) & Rebecca Gonzales (Rebecca.Gonzales@austinisd.org) Lunch is provided daily in the school cafeteria. Healthy snacks are provided twice per day. Students may bring their own lunch and/or snack. Microwaves are available in the school cafeteria. Some field trips may require a sack lunch from home. Each student will also receive a reusable STEAM Camp water bottle and STEAM Camp t-shirt! The AISD Student Code of Conduct will be enforced. A copy is available in the Small MS front office or available online at http://archive.austinisd.org/academics/parentsinfo/conduct_code/. Students who are dismissed from camp due to misbehavior will forfeit registration & tuition fees. The AISD Dress Code will be enforced. A copy is available in the Small MS front office or available online at http://archive.austinisd.org/academics/parentsinfo/dress_code/ Thursday is field trip day! Campers must wear their camp T-shirt. If you forget your camp t-shirt, a replacement fee of $10.00 will be charged. Field trip activity tickets are included in your camp tuition. Sending your child with extra spending money is optional, but camp staff cannot hold money for campers. Each camp will have a pool day! Campers must bring a change of clothes and sunscreen as well as a bathing suit for pool time. Staff members are certified in CPR, first aid, and water safety. Activities: Campers will be divided into groups based on age. Students will engage in activities in the areas of STEAM, Lego Lab, Engineering Challenges, Swimming time, Fun Field Trips, and Games and Recreation! Activities are led by awesome CSMS staff.
Science, Technology, Engineering, Arts & Math (STEAM) Summer Camp 2016 Where Nature s Wisdom Powers Human Innovation Register TODAY! Camper #1 s Name: 2016-17 School: 2016-17 Grade Level: M or F D.O.B.: / / Please check the week(s) that your child will attend camp: Week One: June 13-17 Artist Alive (Texas Spirit Theatre 4D Show & Bowling) Week Two: June 20-24 Digital Storytelling (IMAX Show & Bowling) Week Three: June 27-July 1 Crafting the Mind: Intro to Coding (Main Event) Week Four: July 11-15 Mad Scientist (Mayborn Science Theatre Planetarium) Week Five: July 18-22 Cougar Olympics (Austin s Park n Pizza) T-shirt size (indicate quantity): One shirt per child provided with tuition. Additional shirts are $10.00. CS (6-8) CM (10-12) CL (14-16) AS AM AL (this shirt is very small) If attending multiple weeks, please indicate the number of shirts desired if you don t want a new shirt/water bottle each week. shirts water bottles Camper #2 s Name: 2016-17 School: 2016-17 Grade Level: M or F D.O.B.: / / Please check the week(s) that your child will attend camp: Week One: June 13-17 Artist Alive (Texas Spirit Theatre 4D Show & Bowling) Week Two: June 20-24 Digital Storytelling (IMAX Show & Bowling) Week Three: June 27-July 1 Crafting the Mind: Intro to Coding (Main Event) Week Four: July 11-15 Mad Scientist (Mayborn Science Theatre Planetarium) Week Five: July 18-22 Cougar Olympics (Austin s Park n Pizza) T-shirt size (indicate quantity): One shirt per child provided with tuition. Additional shirts are $10.00. CS (6-8) CM (10-12) CL (14-16) AS AM AL (this shirt is very small) If attending multiple weeks, please indicate the number of shirts desired if you don t want a new shirt/water bottle each week. shirts water bottles
STEAM Camp Registration Information: Child(ren) s Name(s): Address: City: Zip: Guardian s Name: Guardian s Name: Relation to camper: Relation to camper: Home #: Work #: Cell #: Home #: Work #: Cell #: Preferred #: Home Work Cell Preferred #: Home Work Cell E-mail: E-mail: Name and Phone # of emergency contact if Guardians cannot be reached: I authorize Small Middle School to allow my child(ren) to leave with only Guardians listed above and the following persons: Name: _ Phone #: Name: _ Name: _ Phone #: Phone #: If possible, my child would like to be in a group with: Release of Liability I/We assume responsibility and waive any claim for compensation for injury incurred by my/our child(ren) while in camp and hereby agree to indemnify or hold harmless Small Middle School and the STEAM Camp staff against any and all claims, which may arise from an injury to my/our child(ren) while participating in the program. SIGNATURE OF PARENT OR LEGAL GUARDIAN: _DATE: / / I hereby give my consent for Small Middle School to provide transportation to and from field trips and the pool. SIGNATURE OF PARENT OR LEGAL GUARDIAN: _DATE: / /
Medical Information: Child s Physician: _ Emergency Care Facility: _ Phone #: Phone #: Other: Any known medical problems/allergies: _ Medication Will your child need to have medication administered at camp? YES NO If yes, medication dosage time *Note: If your child will need medication administered while at camp, there will be an additional Medication Administration Form for you to fill out when you check your child in the first day. SIGNATURE OF PARENT OR LEGAL GUARDIAN: _DATE: / / Parent Initials: I hereby give my consent for my child(ren) to participate in field trips. I hereby give my consent for my child(ren) to participate in water activities. I hereby give my consent for my child(ren) to eat lunch daily. I hereby give my consent for my child(ren) to eat a snack daily. I hereby give my consent for my child(ren) to appear in pictures used on the school and/or camp website. Names will not be used. I hereby give my consent for my child(ren) to appear in pictures used in camp promotional materials. Names will not be used. Swim level (circle one): 3-4 feet (shallow end of pool) 5 feet & diving board (deep end of pool) Extra staff will be hired for all swim days. All staff are trained in CPR, First Aid, and Basic Water Rescue. Campers will be monitored at all times. Special Comments: SIGNATURE OF PARENT OR LEGAL GUARDIAN: DATE: / /
TUITION PAYMENT STEAM Camp 2015 Tuition: $300/week Non-Refundable Deposit Due at Registration: $100 per week All Tuition Must Be Paid in FULL by June 1 st FORMS OF PAYMENT/DEPOSITS/CANCELLATION POLICY: Please make checks out to Small Middle School. If not paying in full, a non-refundable deposit of $100 per week towards your camp tuition is required upon registration. Cancellation Before May 1 st : will result in refund of all payment minus a $50 processing fee Cancellation between May 1 st June 1 st : will result in refund of payment minus your $100/camp deposit Cancellation after June 1 st will result in forfeiture of all payment Amount Enclosed: $ Amount Still Owed by June 1 st : $ SCHOLARSHIPS: A limited number of partial and full STEAM Camp scholarships are available! To be eligible for a STEAM Camp scholarship, your child must: 1) be headed for CSMS or currently attending CSMS, AND 2) be on free or reduced lunch at school. Note: Scholarship notifications will be made via email by May 15 th. I am applying for a partial scholarship. I am applying for a full scholarship. My child is on free or reduced lunch (check one). I am able to pay and have enclosed $ of the $300 tuition (number can be $0). REQUEST FOR SCHOLARSHIP CONSIDERATION: