STEAM Summer 2021 Registration Form

STEM Initiative Registration

For the 2nd year in Fremont and 4th year in Hayward, we are excited to offer the STEM Initiative, a 4-week summer camp dedicated to empowering the next generation of innovators in the Bay Area. This experience is offered free of charge, at no cost to the student..
Fremont Camp Site: 43475 Ellsworth Street, Fremont CA 94539

Camp Date: 6/9 - 7/, 2025; Camp Hour: 9:00 -3:00 pm, Mon - Fri
Hayward Camp Site: 157 Smalley Ave., Hayward,(Spots are full, No more registration accepted)

Camp Date: 7/7 - 8/8/ 2025; Camp Hour: 9:00 -3:00 pm, Mon - Fri
How do you know us?*
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Attendance Deposit (Refundable Upon Completion)

To ensure that students fully participate, we require a $50 refundable deposit to hold your child’s spot. This deposit will be refunded in full at the end of the program as long as your child attends at least 80% of the session.”
Parent Signature*

Clear
Student General Information
Please select your child's incoming grade level?*
School District?*
School Name?*
Student Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Camp Shirt?*
Parents (guardians) General Information
Mother Full Name*

First NameLast Name
Mother Email Address*

Confirmation Emailexample@example.com
Mother Phone Number*

Area CodePhone Number
Father Full Name*

First NameLast Name
Father Email Address*

Confirmation Emailexample@example.com
Father Phone Number*

Area CodePhone Number
Your support keeps our gears going!! As a nonprofit program, it would not be possible without the continued generosity and financial/material/fiedl trip support. We would greatly appreciate financial contributions of any amount.

donate $20 for a camp shirtdonate $30 for a camp materialdonate $50 for museum field tripOther
My Products*
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Attendance Deposit
It's refundable as long as the student's participation is more than 80%

$50.00 Quantity



Donation for the camp shirt
(optional)

$20.00 Quantity



Donation for the material fee
(optional)

$30.00 Quantity



Donation for the museum visit
(optional)

$50.00 Quantity



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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STEM Initiative Registration

Fremont Camp Site: 43475 Ellsworth Street, Fremont CA 94539

Hayward Camp Site: 157 Smalley Ave., Hayward,(Spots are full, No more registration accepted)

Attendance Deposit (Refundable Upon Completion)

Student General Information

Parents (guardians) General Information