LAUNCH Augusta Camp
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K - 2nd grade Student
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3rd - 4th grade Student
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10.00
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5th - 7th grade Student
$
10.00
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8th - 12th grade Student
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Please review parent handbook.
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Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
Student 1 calc
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Student #2
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
Student calc 2
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Student #3
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.Â
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
Student calc 3
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Student #4
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.Â
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 4
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Student #5
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 5
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Student #6
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 6
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Student #7
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 7
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Student #8
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 8
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Student #9
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
student calc 9
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Student #10
Student's Name
*
First Name
Last Name
Student's Career Goal
*
Student's Age
*
Student's Birthday
*
 -
Month
 -
Day
Year
Date
Student's Gender
*
Female
Male
Prefer not to say
Student's Race
*
Student's Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student's School
*
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Confirmation Email
example@example.com
Student's Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2X
Adult 3X
Any allergies or health concerns?
*
Yes
No
If answered "yes" to previous question, please specify.
Has this Student attended LAUNCH Camp previously?
*
Yes
No
If answered "yes" to previous question, please specify which year(s) this Student attended LAUNCH camp. (Select all that apply)
2017
2018
2019
2020 virtual
2021
2022
Has this Student completed any healthcare courses in school or is this Student currently enrolled in any healthcare courses in school?
*
Yes
No
If answered "yes" to previous question, please list the courses below.
Information for LAUNCH camp will be sent out via email. Is it okay to notify you via text when we send important emails?
*
Yes
No
For funding and data collection purposes: What is the total number of people in your family unit? (Including Student and Parent that is completing this form).
*
For funding and data collection purposes: What is the gross household yearly income?
*
less than $20,000 per year
$20,000-$30,000 per year
$30,000-$40,000 per year
$40,000-$50,000 per year
$50,000-$60,000 per year
$60,000-$70,000 per year
$70,000-$100,000 per year
greater than $100,000 per year
For funding and data collection purposes: What County does the student reside in?
*
For funding and data collection purposes: Is the Parent of this Student in the Military (Active Duty or Reserve)?
No
Yes
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