WISL Python Programming Summer Camp Registration Form
Monday, June 8 – Friday, June 12, 2026. Time: 8:30 a.m. – 1:30 p.m.
Student Full Name:
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Age
Gender
Female
Male
Don't want to identify
Grade (2025–2026 school year):
School Name:
T-Shirt Size (Circle One):
Please Select
Youth S
Youth M
Youth L
Youth XL
Adult X
Adult M
Adult L
Parent/Guardian Full Name:
Relationship to Student:
Primary Phone Number:
Parent/Guardian E-mail
example@example.com
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does your child have any medical conditions, allergies, or special needs we should be aware of?
No
Yes (Please explain in the comments section)
Is your child currently taking any medication?
Yes
No
Has your child had prior coding experience?
No experience
Scratch
Python
Other
I grant Women in STEM Leadership permission to photograph or record my child for educational and promotional purposes (website, social media, flyers, reports).
Yes
No
I understand: My child must attend all five days if possible. Drop-off is at 8:30 a.m. and pick-up is at 1:30 p.m. A signed Minor Waiver is required before attendance. WISL reserves the right to dismiss students for disruptive behavior.
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