Student Name
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First Name
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Grade Level (2026/2027)
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Grade 3
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Gender
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Second Student
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Health and Medical Information
Please fill in the following information carefully.
OHIP Number
Allergies (Include treatment)
Health History (Diabetes, Epilepsy, Etc.)
Additional Student
*
Parent and Guardian Information
Please fill in the following information carefully.
Parent Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
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*
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Format: (000) 000-0000.
Parent Email
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Alternative Contact
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Relationship to Student
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Father
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Format: (000) 000-0000.
Email
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Port Elgin Summer STEM Camps
Summer, 2026
July
July 6-10 [VEX IQ]
Yes
No
Number of Students
July 13-17 [Sphero RVR+]
Yes
No
Number of Students
July 20-24 [VEX IQ]
Yes
No
Number of Students
July 27-31 [Sphero Bolt+]
Yes
No
Number of Students
August
August 10-14[VEX AIR Drones - Grades 6 & 7]
Yes
No
Number of Students
August 17-21 [VEX IQ & AIM]
Yes
No
Number of Students
August 24-28 [VEX AIR Drones - Grades 6 & 7]
Yes
No
Number of Students
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Please read the relevant Terms and Conditions found on
STEMVOX's website.
I have read and provide consent to the following forms.
STEMVOX Owen Sound Robotics Camps
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( X )
July 6-10
VEX IQ
$
450.00
CAD
Quantity
1
2
Item subtotal:
$
0.00
CAD
July 13-17
Sphero RVR+
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
July 20-24
VEX IQ
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
July 27-31
Sphero Bolt+
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
August 10-14
VEX AIR Drones (Grades 6 & 7)
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
August 17-21
VEX IQ and VEX AIM
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
August 24-28
VEX AIR Drones (Grades 6 & 7)
$
450.00
CAD
Quantity
1
2
3
4
5
6
7
8
9
10
Signature
*
Register
Register
Should be Empty: