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2005 Astronomy & Rocketry Summer Camp Registration

Registration Form

Download printable Registration form

Morgan County Observatory Foundation

2005 Astronomy & Rocketry Summer Camp Registration Form

Last Name:____________________ First Name:________________ MI: ___

Street: __________________ City:_______________ State:____ Zip: ____

Phone:________________ Gender:_____ Birthdate:___________ Age:______

Parent/Guardian’s Name:________________________ Phone:_____________

Emergency Phone & name:_________________________________________

Who will be providing transportation:__________________________________

Desired week of attendance:_______August 1-5 ________August 8-12

Cost: $50 per week, per child with $20 deposit due with registration.

Full scholarships are available on a self determined scale upon request.

Funding for this program has been granted by the Jane Snyder fund of the Eastern WV Community Foundation. Children must be over 8 years of age.

Please make check payable to MCOF or Morgan County Observatory Foundation and send to MCOF 81 Sparrow Trail Berkeley Springs, WV 25411.

This is a one week camp repeated over the second week, not a continuous two week program. Children may attend both weeks, but there will be some repetition of content. Space is limited.

I grant permission for my child to participate in all activities of this camp and assume all risks and hazards incidental to such participation, including transportation to and from such activities, and I do hold harmless the Morgan County Observatory Foundation, Morgan County Schools, and any and all volunteers, staff and organizers for any claims arising out of injury to my child except to the extent and in the amount covered by the accident or liability insurance carried by such persons.

I further grant permission for emergency first aid to be given to my child in case of injury. If deemed necessary, I grant permission for my child to be taken to the emergency room of a nearby hospital, and the hospital and it’s staff have my authorization to provide treatment which a physician deems reasonably necessary for the well being of my child.

Parent/Guardians Signature____________________________________________________________

Date:________ Amount Due:____________ Amount Paid:___________


Any questions, call 304-258-1013

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