High School Arduino Camps – Summer 2026 Application Program InformationApply for Electronics for Beginners and/or Electronics for Intermediate Users. Students may apply for one or both camps. Students will learn the basics of programming in a variant of the C++ language as well as leverage their critical thinking skills to come up with innovative designs. Participants must commit to all session days.Student InformationFull Name *Preferred NamePreferred PronounsGender *Personal Email *School Email *Mobile Phone *Home Address *City *State *Zip Code *School Name *Student Involvement InformationList School Involvement and Activities *List Community Involvement and Activities *Which camp are you applying for?Electronics for Beginners (Monday, June 8 through Thursday, June 11, 2026, from 9 a.m. to 3 p.m.)Electronics for Intermediate Users (Monday, June 15 through Thursday, June 18, 2026, from 9 a.m. to 3 p.m.)Both – Electronics for Beginners and Electronics for Intermediate UsersBriefly describe your interest in Electronic for Beginners and/or Electronics for Intermediate Users, what you hope to gain, and how you expect to utilize your program experience. *ReferencePlease list the information for a teacher, career counselor, or guidance counselor. They will be contacted to complete a reference form.Name *School District *Email *Phone *CommitmentCamp DatesElectronics for Beginners: Monday, June 8 through Thursday, June 11, 2026, from 9 a.m. to 3 p.m. Electronics for Intermediate Users: Monday, June 15 through Thursday, June 18, 2026, from 9 a.m. to 3 p.m.Will you be able to attend all camp days for which you are applying and commit to creating a project? *YesNoWill you be enrolled in grades 9-12 during the 2026-2027 school year? *YesNoI understand the purposes of the Arduino camps and, if I become a participant, I will devote the time and energy necessary to make it a successful experience and will use this experience to develop my leadership skills in my school the community.Student Signature *Start signing your signature hereYour browser does not support e-Signature field.Parent/Guardian InformationName *Your Relationship to Student *Email Address *Phone *Home Address *City *State *Zip Code *Emergency Contact Name *Other than yourselfEmergency Contact Phone *Emergency Contact Relationship to Student *Parent/Guardian Liability Release *I agreeRecognizing the educational benefits of this program and acknowledging that it is voluntary, I agree to assume responsibility for my child’s safety and welfare while participating in the High School Arduino Camps program and hereby release the Richland Area Chamber & Economic Development, The Ohio State University at Mansfield, The 179th Cyberspace Wing and its agents from any liability for injury or damage arising out of the program.Parent/Guardian Medical Release *I agreeA physician will treat your child if the need arises while he/she is attending the program. In the event of serious illness or injury, you will be notified. If you are unavailable, necessary emergency treatment will be arranged.Please list the student's allergies.Promotional Release *I agreeI declineI give the Richland Area Chamber & Economic Development, the Ohio State University at Mansfield, and the 179th Cyberspace Wing permission to use my child’s photo in various social media posts, advertising, and promotional brochures.Is there anything else we need to know about your student to ensure they have a wonderful experience at the Arduino camp(s)?Parent/Guardian Signature *Start signing your signature hereYour browser does not support e-Signature field.The Richland Area Chamber & Economic Development does not discriminate on the basis of race, color, national origin, sex, disability, age or religion. SubmitSave as Draft