Registration Form ick the right Program for you ick the right Program ...

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Fax: (580)310-2286. Mail or fax in registration form to: 601 West 33rd Street. Ada, OK 74820. Name. Male Female. Address
ick the right Program for you

Students entering 7th-9th Grades can pick their top three choices of camp they want to attend!

Salon Style Are you ready to look like you just stepped out of a salon? Sign up for this camp and learn do-it-yourself tips from industry professionals. Discover how to use simple styling tools to create today’s trends, go beyond the basics of braiding, give manicures and pedicures. In addition to expressing your creative side, you’ll also get a look at the science behind the style! 

Registration Form Are you a person that enjoys science and helping others? Be a health care hero and help a patient go from injury to recovery. Participate in the diagnosis and treatment of a patient in a simulated facility, and learn about the pharmaceutical industry.

If you love science, CSI, and Bill Nye the Science Guy, then the Fun with DNA camp  should fit you well. You will conduct activities and experiments designed to build a foundation in biological sciences. Through model-making, microscope observations, and laboratories – including DNA extraction and genetic engineering – students will build an understanding of cell biology, microbiology, genetics, and biotechnology.

It won't be long before you'll be in the driver's seat, and this camp will teach you what you need to know to make sure your ride stays running smooth.  Auto 101 will prepare you to take care of your vehicle.  Students will learn how to check everything under the hood, under the car and service a flat tire.

(7th-9th Grade)

Please mark your 1st, 2nd, and 3rd choices. Space is limited. we will do our best to place everyone in their ideal camp. Registration is on a first-come, first-served basis. salon style

Fun with dna

Automotive 101

Lights...Camera...Action!

health

Male

Name

Address

City

Parent E-mail Emergency Phone Home Phone School Name

State

$50 includes Snack and T-shirt students from Ada, Allen, Byng, Latta, Roff, Stonewall, Sasakwa, Vanoss, and tupelo school districts are all welcome!

Mail or fax in registration form to:

601 West 33rd Street Ada, OK 74820

PHone: (580) 310-2253 or (580) 310- 2278 Fax: (580)310-2286

Zip Code

7th

Grade you will be entering August 2016

XL

8th

2XL

9th

3XL

Payment Method Check/Money order

Visa

Mastercard

Discover

Card Number Expiration Date Signature

Release for Necessary Medical Care and liability.

I hereby consent to any medical treatment for any symptom or condition which, in the opinion of the camp director of of any attending medical personnel, shall be deemed necessary or advisable. Subject to the foregoing provisions, i agree to hold harmless and without fault Pontotoc Technology Center, all officials or administrators thereof, and any teacher of other school representative for any injury to my child which may arise our of or in the course of activities during the camp. During this week, i can be reached by the phone numbers listed above.

Signature

Permission for Photographs

Photos of students will be taken throughout the camp. Please sign the release below indicationg permission for your child to be photographed for camp photos and promotions.

I hereby grant permission for during camp.

Signature * Pontotoc Technology Center does not discriminate on the basis of race, color, national origin, sex, disability, or age. Contact Susie Overturf, Director of Information Technology 580-310-2280 or Bennie Cope, Fire & Safety Coordinator 580-310-2276

Female

Cell Phone

Adult T-Shirt Size S M L *List any special Accomodations

Lights...Camera...Action!

Automotive 101

June 6th - 10th ~ $50

Fun with DNa

01101110000 01001011

Interested in cameras, acting, writing, video editing?  Check out LIGHTS...CAMERA...ACTION!  Learn how to put together a student driven news broadcast.  Whether you want to be onscreen talent, or the technical director, this will be the short course for you!

Mail/fax in by May 27th

Health

to be photographed