Be Great Foundation - GEMS IN STEM Scholarship Program

Be Great Foundation - GEMS in STEM Scholarship Application

Through Partnership with iDTech
Thank you for your interest in particpiating in our GEMS in STEM Spring Break Camps. We are so excited for your family, and especially your little one as they tap into the genius that lies within and explore an innovative area within STEM that they will be excited about for years to come.

We have a limited number of scholarships so we will use a lottery system to select participants until we are able to fulfill all scholarships. These camps are typically priced at $500 and up, so we ask that you ENSURE YOUR CHILD IS AVAILABLE TO PARTICIPATE IN ALL SESSIONS. If your child misses any sessions, or does not complete their program they will be excluded from any future programs and offerings by Be Great Foundation.

Please select the camp that you would like you child to enroll in. Times may vary by offering.

Finally, to conclude the GEMS in STEM Camps we will be hosting a pizza party and esports tournament at Transform GSO on July 23rd, we truly hope your child can attend as this will be a fun time to meet other campers as well as your hosts at the Be Great Foundation.
Participant's Name

First Name Last Name
Birth Date

Month Day Year
Grade
School
Gender

Male Female
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian Information
Name

First Name Last Name
Home Number
Cell Number
E-mail
[email protected]
Emergency Information
Emergency Contact's Name

First Name Last Name
Relationship
Phone Number
Alt. Phone Number
Can your child commit to attending all sessions?
Does your child have any allergies or dietary restrictions? If so, please specify below.
Does your child(ren) have access to a laptop device and reliable internet that they may use for specified sessions?

Yes No
Please select a CAMP offering below based upon age group 10-12. *

Minecraft Adventure Design Minecraft Modding & Java Coding Python Coding & Arcade Game Design Roblox Game Design: Coding & Monetization Coding Games: Javascript and P5 Startup Camp with Daymond John Make a YouTube Channel: Animation & Storytelling Trickshot Editing with Dude Perfect Roblox Game Design: Develop a Business Tycoon Game Javascript Game Development RPG Maker
Please select a CAMP offering below based upon age group 13-17. *

3D Game Development and Level Design Minecraft Modding & Java Coding Coding Apps with Java Roblox Game Design: Coding & Monetization Coding Apps & Games with C++ Entrepreneurship with Daymond John Make a YouTube Channel: Animation & Digital Shorts Trickshot Editing with Dude Perfect Unity Game Design: First Person Battle Arena Javascript Algorithms: Pathfinding and AI
How did you hear about this opportunity? *
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in the GEMS in STEM Spring Break program by {Organization} during the specified date/time of the camp offering selected above. In exchange for the acceptance of said child’s candidacy by {Organization} , I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless {Organization} and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against {Organization} . including all staff, participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Additionally, I hereby authorize Be Great Foundation to utilize photos and videos that may be captured during this workshop for purposes of marketing, media or program evaluation. Be Great Foundation certifies that all video and images will be utilized in a manner that is appropriate, professional, and favorable for the child/family. Any specific potential media opportunities will be discussed with parents/family prior to the event to ensure all parties are in agreement.
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.
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Be Great Foundation - GEMS in STEM Scholarship Application