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121 Brown School Dr, Grantville, GA 30220 (770) 253-4632 FAX: 770-254-2730 For Student Field Trip Information: 770-583-9004
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Amazing Science Tricks June 13 - 16, 9:00AM to 12:00PM
Explore, Explode, Examine June 13 - 16, 9:00AM to 12:00PM
Fantastic Science June 13 - 16, 9:00AM to 12:00PM
Illusions of Science June 13 - 16, 9:00AM to 12:00PM
Robots, Rockets, and Robotic Bugs June 13 - 16, 8:30 a.m. to 12:30 p.m.
Robots, Rockets, and Robotic Bugs June 27 - 30, 8:30 a.m. to 12:30 p.m.
CHILD'S NAME GRADE CHILD WILL ENTER IN FALL
NAME OF SCHOOL CHILD ATTENDS
PARENTS' NAMES PARENT'S EMAIL
HOME ADDRESS STREET
CITY STATE ZIP CODE HOME PHONE
WORK PHONE EMERGENCY CONTACT
WAIVER
I give my permission for my child to participate in a summer camp sponsored by Shenandoah GYSTC. I understand that all activities will be planned and conducted by GYSTC personnel and Coweta County teachers and that safety precautions will be taken during all activities. In the event that an accident does occur, I will not hold GYSTC or the Coweta Co. School System, their employees or volunteers responsible for any accidental injuries.
If emergency treatment or advice is considered necessary by the GYSTC staff, I understand that the listed physician and parent or guardian will be notified. If we cannot be reached, I authorize Shenandoah GYSTC to arrange whatever emergency treatment is considered necessary.
Physician's Na me Physician's Phone Number
Hospital
Please list any allergies, physical limitations, and special medications.
Please submit the fee to Shenandoah GYSTC by May 1, 2010. Spaces are limited.
Ask about our multi-child discount! Please add 10% for payment after May 1.
121 Brown School Drive, Grantville, GA 30220 Phone (770) 253-4632 FAX (770) 254-2730
Website: www.shenandoahgystc.org
Questions? Contact dstuckey@shenandoahgystc.org
Shenandoah GYSTC 121 Brown School Dr, Grantville, GA 30220 (770) 253-4632 FAX: 770-254-2730 For Student Field Trip Information: 770-583-9004 Home Contact Us State Headquarters