2008 Astronomy & Rocketry Summer Camp Registration

Last Name:____________________ First Name:________________ MI: ___

Street: __________________ City:_______________ State:____ Zip: ____

Phone:________________ Gender:_____ Birthdate:___________ Age:______

Parent/Guardian´s Name:________________________ Phone:_____________

Emergency Phone & name:_________________________________________

Who will be providing transportation:__________________________________

Time: 9AM to 12:30PM at Morgan County Observatory

Desired week of attendance:_______August 4-8 ________August 11-15

Cost: $80 per week, per child with $20 deposit due with registration. $20 discount for multiple siblings. Scholarship assistance based on self assesed need will become available pending future grant receipts

Children must be 8 years of age or older.

Please make check payable to MCOF or Morgan County Observatory Foundation and send to MCOF, 81 Sparrow Trail, Berkeley Springs, WV. 25411.

This is a one week camp repeated over the second week, not a continuous two week program. Children may attend both weeks, but there will be some repetition of content. Space is limited.

I grant permission for my child to participate in all activities of this camp and assume all risks and hazards incidental to such participation, including transportation to and from such activities, and I do hold harmless the Morgan County Observatory Foundation, Morgan County Schools, and any and all volunteers, staff and organizers for any claims arising out of injury to my child except to the extent and in the amount covered by the accident or liability insurance carried by such persons.

I further grant permission for emergency first aid to be given to my child in case of injury. If deemed necessary, I grant permission for my child to be taken to the emergency room of a nearby hospital, and the hospital and it´s staff have my authorization to provide treatment which a physician deems reasonably necessary for the well being of my child.

Parent/Guardians Signature____________________________________________________________

Date:________________ Amount Due:_____________ Amount Paid:____________

Method:____________

Any questions, call 304-258-1013

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This Page Last Updated - April 27, 2008