BrainSTEM 2025 Virtual Camp Registration

Student Name *

First

Last

Student Age Group *8-11 years old12-14 years old

Guardian Name *

First

Last

Guardian Email *

Guardian Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone

Choose Your Camp(s) *

• Week 1 – $60.00
• Week 2 – $60.00
• Week 3 – $60.00

Total

$0.00

Stripe Credit Card *

Credit Guardian Guardian

Custom Captcha *

=

Register