Coda Explore 2019
Coda Explore is a summer day camp for students in grades 6-12. Students will learn about the engineering world through hands-on activities, interactive games, and classroom instruction. Activities will include Lego Mindstorm Robotics, project-based learning, STEM activities, outdoor/survival skills, and programming principles. . WHEN: June 17-21, 8:30-2:00. WHERE: 2855 Maple Ave. Fayetteville, WV 25840 COST: $150. FREE lunch included, with optional breakfast at 8am (parents and siblings are welcome to join us for breakfast too!). Limited scholarships available. Payment button below.
Student Name
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Parent/Guardian 1
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6th
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Level of Skill
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No Experience with Lego robotics
Has Wedo experience
Has Mindstorm experience
T-shirt size
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This number belongs to?
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Parent/Guardain 1
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Parent/Guardian 1
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Email
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Coda Robotics Camp 8:30 AM - 2:00 PM
Breakfast will be served each morning at 8:00, before classes start at 8:30. Lunch will be served at 12:00
How many of you will be joining us for breakfast? (Parents and siblings welcome to join.)
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None
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4
Already answered in sibling application
How many of you will be joining us for lunch?
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None (My child will leave at noon)
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Already answered in sibling application
Food Allergies/ Special Dietary Restrictions
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Material Use Policy
Our robotics equipment is provided for your child's use, in order to create a fun and exciting learning experience. Your child is expected to take care of and respect this equipment, so that it is not damaged and is able to be used by other students. Failure to do so will result in a fine equivalent to the cost to replace damaged equipment.
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I have read and agree to the above stated policy
Most Recent School attended
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Photo Waiver
Understanding that Coda photos and videos are important to promote public awareness, access future scholarship funding and reach more youth, I hereby consent for my child (or myself if 18 or older) to be photographed and/or videoed for Coda Mountain Academy. The resulting photographs or videos may be subsequently used without compensation to me by Coda Mountain Academy, or third parties for publications (including web sites,) advertising, and/or publicity purposes at the discretion of Coda Mountain Academy. Some photos and videos will be used in the year end grant report. I waive the right to inspect or approve the finished photograph, video and/or publication use.
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I, parent or guardian, consent to the above photo/video waiver for Coda.
I, parent or guardian, do NOT consent to the above photo/video waiver for Coda.
Signature
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Medical Release
Emergency Contact (this is who we reach out to if we cannot reach Parent/Guardian 1 or Parent/Guardian 2)
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First Name
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Phone Number
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Relationship to student
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Release
I, the undersigned, am the parent or legal guardian of this minor and have given my consent for him/her to participate in activities hosted by Coda Mountain Academy. In the event of injury, accident, illness or other emergency while participating in the camp, I consent to any reasonable medical treatment as deemed necessary by a licensed physician, emergency medical technicians, nurses, and laboratory technicians. In the event any treatment is required, which a physician and/or hospital personnel refuses to administer without my consent, I hereby authorize Esther Morey, Robert Morey, Tim Bailey, Becky Bailey, or an associated adult supervisor to give such consent for me, if I cannot be reached by telephone at one of the numbers listed above, or because of an emergency in which there is no time or opportunity to make a telephone call. In the event it becomes necessary for that person to give consent for me, I agree to hold such person, other associated adults and Coda Mountain Academy free and harmless of claims, demands, or suits for damages which may arise from the giving of such consent. I also acknowledge that I accept to be ultimately responsible for the cost of any medical care whether or not the cost of that medical care will be reimbursed by my health insurance provider. Further, I affirm that the health insurance information provided in the medical release form is accurate as of this date. I further authorize disclosure of medical information by a treating physician to Esther Morey, Robert Morey, Tim Bailey, Becky Bailey, or associated adult supervisor as permitted by The Health Insurance Portability and Accountability Act of 1996 (HIPAA).
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I have verified the above details are correct and that I have read this release and agree with the content.
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Tuition
$
150.00
There are limited scholarships available.
Please email me a scholarship form
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