Electronics for Beginners Application Program InformationThis Arduino camp will walk high students through 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. The camp takes place on Monday, June 24 through Thursday, June 27, 2024 from 9 a.m. to 3 p.m. at Mid-Ohio Educational Service Center. Participants must commit to all sessions.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 *Briefly describe your interest in Electronic for Beginners, 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 DatesJune 24 through June 27, 2024 from 9 a.m. to 3 p.m.Will you be able to attend all four camp days? *YesNoWill you be enrolled in grades 9-12 during the 2024-2025 school year. *YesNoI understand the purposes of the Electronics for Beginners program 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 Electronics for Beginners program and hereby release the Mansfield-Richland Area Educational Foundation 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 declineI agreeI give Mansfield-Richland Area Educational Foundation 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 in the Electronics for Beginners camp?Parent/Guardian Signature *Start signing your signature hereYour browser does not support e-Signature field.Mansfield-Richland Area Educational Foundation does not discriminate on the basis of race, color, national origin, sex, disability, age or religion. SubmitSave as Draft