Clarkston Community Center STEAM Plus Summer Camp

Clarkston Community Center STEAM-Plus 2021 Summer Camp Registration Form

First week of camp is free. Starting June 15th, we will start accepting weekly payments of $35. Campers will be separated into groups based on grade level and will be socially distanced.
Child's Information
Parent(s)/Guardian(s) Information
Please list in order of whom to contact first *
Demographic Information
If other please type in your demographic information:
Parent's Highest Level of Education (please select one):

Did not complete High School High School Diploma/GED Technical/Vocational School Some College Associates Degree Bachelor's Degree Advanced Degree
Country of Origin
Primary Language
English Speaking Level (Select One):

Fluent Intermediate Beginner None
English Reading Level (Select One):

Fluent Intermediate Beginner None
English Writing Level (Select One):

Fluent Intermediate Beginner None
What is your child's gmail account? (You & your child will receive important updates)
Would you like to participate in our Youth Decoded Course? (Youth Decoded is an in-depth coding program provided by the DeKalb County Offices of Youth Services)

Yes No
Do you have access to a home desktop or laptop?

Yes No
Does your child(ren) receive free or reduced lunch?

Yes No
Annual Income
If you are eligible, are you interested in receiving a DeKalb County summer camp voucher (must be a resident in DeKalb County)?

Yes No
Date of Registration

Month Day Year
Date
Questions? Please contact Eric Williams at 404-508-1050 or email at youth@clarkstoncommunitycenter.org.
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Clarkston Community Center STEAM-Plus 2021 Summer Camp Registration Form

Child's Information

Parent(s)/Guardian(s) Information

Questions? Please contact Eric Williams at 404-508-1050 or email at youth@clarkstoncommunitycenter.org.