Cyber Camp Registration Form

Welcome! We're glad you're interested in the Cyber Camp at Montana Western, June 15th-19th (8:30-3:00), instructed by Sarah Gibson. Twenty campers will attend this all-inclusive week-long event which will include lessons and application of Cybersecurity awareness, Scratch coding, assembling Raspberry Pi hardware, Cisco networking basics, and many other STEM activities. Lunches and snacks will be provided during the camp. Completion of this form does not mean you automatically have a spot at the camp. Watch your email, and perhaps your spam filter, for official confirmation of your invitation to the camp. Slots are limited to twenty and the rest will be put on a wait list.

Payment of $50 will be due to the Outreach office at close of registration on May 22nd. We will accept cash, check or credit card.

Questions: Contact the Outreach office at 406-683-7537 or outreach@umwestern.edu
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade in School (Fall 2025)*
Age During Camp*
T Shirt size
(Youth s, m, l, xl or Adult s)
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Should be Empty:

CHILD INFORMATION: