Merrick Avenue Middle School

Technology (C)

Summer STEAM Camp (Incoming 7th) WEEK 2 - July 21st-25th

Dates: Monday July 21st - Friday July 25th Time: 9:00 - 12:00 Location: Merrick Avenue Middle School

Camp Start Date:

April 21, 2025

Start Time:

9:00:00 AM

Camp End Date:

April 25, 2025

End Time:

12:00:00 PM

Date Details:

ONE WEEK PROGRAM: Week 2

Venue Name:

Merrick Avenue Middle School

Venue Address:

1870 Merrick Avenue, Merrick, NY 11566

Camp Cost:

$150.00

Questions:

Danielle Caliendo

(631) 992 - 1342

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Summer STEAM Camp (Incoming 7th) WEEK 2 - July 21st-25th

First Name *
Last Name *
Mobile *
Email *
Grade *
Birth Date *
Address *
City *
State *
Zip Code *
Medical Information *

List Medications/Medical Conditions here. If none, type N/A

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Guardian First Name *
Guardian Last Name *
Guardian Cell Phone *
Guardian Email *
Alternate Guardian First Name
Alternate Guardian Last Name
Alternate Guardian Phone
Alternate Guardian Email
Medical Release Information

Guardian Signature *

I, the parent/legal guardian, agree entirely to the Medical Release Information.: clear

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Merrick Avenue Middle School Technology (C)

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$150.00

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CAMPER INFORMATION