DDAAT-App! STEMM+ Camp Enrollment Form

The Flourish Foundation Project Inc and as Flourish Foundation Inc (DBA DDAAT-App! (TM) Mentoring & Counseling), we help build stronger communities through collaboration, community engagement, and the creation of mental health support programs.

We specialize in uniting people, businesses, human service & nonprofit agencies, together creating the foundational framework of collaborative programs which support safe & caring communities.

Understanding the national teen suicide crisis disproportionately impacts children of absent father households and are 63% more likely to attempt suicide, our programs we offer DDAAT-App! STEMM+ (TM) Camp which during FFP)

Our DDAAT-App! (TM) mobile application, and DDAAT-App! STEMM+ (TM) Camp & After-school programs uniquely supercharges standard STEM education by combining life skills, career exploration, peer support, and suicide prevention strategies into highly engaging STEM plus, music production & engineering, digital animation & graphic art, and community engagement activities.

Objectives;

^Support Teen Mental Health

^Youth & Young Adult Suicide Prevention

^Increase high school graduation rates &

STEM college & community college

enrollment

^Reduce instances of absent father crisis associated

Youth are empowered avoid suicide and self-harm while embracing life & building bright futures in STEMM+ career paths!

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Please complete and submit one form per student being enrolled in the After School Program.
DDAAT-App! STEMM+ Plus Camp Enrollment Form

Session 1: 2023 Spring Break April 7-April 14
DDAAT-App! STEMM+ Plus Camp Enrollment Form

Session 1: 2023 Spring Break April 7-April 14
Parent's Name*

First NameLast Name
Parent's Phone Number*

Area CodePhone Number
Parent's Email*
Student's Name*

First NameLast Name
Current Grade Level (2022-2023)*

Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12
Please check the desired STEMM+ Camp Session for which you are enrolling. Please complete a separate form for each session per student and for each session.*

Session 1: 2023 Spring Break April 7-April 14Session 2: 2023 Summer June 12-August 25
I acknowledge STEMM+ Camp days are Monday - Friday only. Parent/Guardian is responsible for transportation to and from STEMM+ Camp. *

Yes, I acknowledge and agree.
I acknowledge STEMM+ Camp will provide a bag lunch and snack each day. Parents may provide a bagged lunch for students with special dietary restrictions. Parents are responsible for providing written notice of student allergy and or dietary restriction before the first day of enrollment.*

Yes, I acknowledge and agree.
Please note any known allergies and or dietary restrictions:
I permit my child to ride the activity bus for Friday field trips. I release Flourish Foundation Project Inc DBA DDAAT-App! Mentoring & Counseling, STEMM+ Camps, and its affiliate or partner organizations from liability for injury and/or accident. *

Yes, I acknowledge and agree.
Please specify each person, including the name of parents, who has permission to pick up your child from the STEMM+ Camp Programs. Picture ID will be required for pick up.
Authorized Person 1:

First NameLast Name
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Phone Number 3:

Area CodePhone Number
Statement of Fees

A $50 Non-refundable registration fee is due at the time of enrollment for each child/student per STEMM+ Camp session. Weekly tuition is due in full by the FRIDAY BEFORE the enrollment week. The STEMM+ Camp Program ends promptly at 5:30 p.m. After 5:45 p.m., a late charge will be assessed at the rate of $10.00 for each 15 minute interval or fraction thereof.
Statement of Policy
- An Enrollment Form is required for all students participating in this program.
- The STEMM+ Camp Program ends promptly at 5:30 p.m. After 5:45 p.m., a late charge will be assessed at the rate of $10.00 for each 15 minute interval or fraction thereof.
I have read and understand the Statement of Fees and Statement of Policy contained here.*

Agree
- Only persons authorized by the parent or guardian may pick up your child from the After School program. Please notify the Director in writing if anyone other than a parent/guardian will pick up your child. Picture ID will be required.
- All students attending the STEMM+ Camp Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Students with a fever or contagious illness may not participate in the program.
- This program is available for all currently enrolled Cannon students, grades 3 and up, ages 8 and up.
I give Flourish Foundation Project Inc DBA DDAAT-App! Mentoring & Counseling STEMM+ Camp Program permission to bill my provided debit/credit card account for the STEMM+ Camp Program services as indicated on this Enrollment Form, according to the Statement of Fees.*
Should be Empty:

DDAAT-App! STEMM+ Plus Camp Enrollment Form

DDAAT-App! STEMM+ Plus Camp Enrollment Form

Statement of Fees

Statement of Policy