STEAMVE$TMENTS Seminar Registration Form

Seminar Registration

Each student will need a separate registration form completed

STEAMVE$TMENTS 2026 is offering the following seminars this summer FREE to students. There is limited space available in each seminar. Therefore, it is important to complete the registration with parental consent as soon as possible. Please note the specific details identified below, before you select the seminar you would like to attend:

Seminar	Description
Exton, PA: June 28-July 1, 2026	4 days, 3 nights sleepaway camp for grades 6-9 only
Windsor, CT: July 9-11, 2026	2.5 days typically 9 am-5 pm for grades 6-12
Iowa City, IA: July 16-18, 2026	2.5 days typically 9 am-5 pm for grades 6-12
Springfield, MA: August 13-15, 2026	2.5 days typically 9 am-5 pm for grades 6-12
New Haven, CT: August 20-22, 2026	2.5 days typically 9 am-5 pm for grades 6-12

Select Seminar*
Select the seminar you would like to attend.
Student Information
Student's Name*

First NameLast Name
Student Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student Email Address*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Age*
Student Grade (in the Fall)*
MaleFemale
Student Race/Ethnicity
YesNo
YesNo
Transportation Pickup Address
Name & Location of School*
Please list all allergies, including food allergies, below:
What is your current knowledge about STEAM careers?
What are your favorite subjects in school?
Which subjects do not capture your interest?
YesNo
Student T-Shirt Size (Adult)*
School Counselor Full Name
School Counselor Phone
School Counselor Email Address
How did you learn about STEAMVE$TMENTS?
Why do you want to attend STEAMVE$TMENTS (2 - 3 sentences)?*
How do you feel about being at a sleepaway camp for 3 nights?*
Parent/Guardian Information
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Phone Number*
Format: (000) 000-0000.
Parent/Guardian 1 E-mail*
example@example.com
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Phone Number
Format: (000) 000-0000.
Parent/Guardian 2 E-mail
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship
Phone Number*
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Should be Empty:

Seminar Registration

Seminar

Description

Student Information