Cooper STEM Summer Camp May 30-June 2, 2022 from 8:30 am-11:30 am

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Camp Sign-Up

Email *

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Student's Name *

You must be a Cobb County student, zoned for Cooper MS, to receive transportation and to attend camp.

Cobb County Student ID# *

This is your lunch number.

What grade will you be in next year (in the fall of 2019)? *

7th grade

8th grade

Date of Birth *

YYYY

Your home address *

Street Address, City, State, and Zip Code

Transportation from camp to home (at 11:30 am) *

Bus Rider

Car Rider

Walker

Does the student require special transportation? *

Yes

If you check bus rider, where is your current bus stop?

Please provide the name of the streets (intersection) where you are picked up by the school bus.

Parent/Guardian's Name *

Relationship *

(mother, father, guardian, etc.)

Email Address *

Phone numbers *

(home, cell, work, etc.)

Allergies *

Emergency Information

Medication (that should be taken at school). *

Please respond with none if medication is not necessary. Please be aware there will not be a nurse on duty. Student must be able to self-administer medicine.

Additional information we need to be aware of: *

Does student wear contacts, glasses, etc.

I am aware I must provide transportation for my student to Cooper Middle School between 8:00-8:30 am each day of the camp. Bus transporation will be provide to take the student home at 11:30 am. *

Yes

Please sign up for Remind101 so you can receive alerts from camp. To join text @6eh9d6 to the number 81010. *

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