2023 Camper Info – Becker County Museum

Student First/Last Name *

Parent/Guardian First/Last Name *

Address *

City, State, Zip

EMail *

EMail If Different During Camp Time

Phone *

In case of emergency please contact: Name 1 *

Phone 1 *

In case of emergency please contact: Name 2

Phone2

In case of emergency please contact: Name 3

Phone 3

Emergency Options And Photos *

In Case of Emergency, I give consent to seek medical treatment

I give consent for my child’s picture to be taken and for the Becker County Museum to use for advertising and publications

My child will be :

attending another camp at the Historic Holmes Theatre or DLCCC and will need to be escorted.

picked up by:

Name Of Pickup Person

For STEAM or Technology Related Camps Please read the following and type your name to accept. electronic and mechanical parts can be delicate, procedures must be followed. We take the best care possible to insure all parts are working pre tested, if a student damages a part we will do our best to assist to get a good result but diagnosis after camp has ended or replacement parts may cause addition charges before a working product is realized. Type your name below to acknowledge this. *

For Robotics Camp ONLY Since the students will keep their robots they may wish to pair with and program with their own device, That also limits the number of loaners we need to provide, we will provide Museum devices as needed so don’t worry if you do not have a device available but if you do check the box(s) that apply I have and will send with my student

For Coding Camp and Robotics Camp and Computer Camp Please make sure your student can type at least at a basic level with understanding, we will walk them through the specific code but they must be able to keyboard enough that they could type a paragraph *

YES My Superstar can type!