Summer Math Boot Camp 2023

Parent Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Address 1:
• Address 2:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• *

  Ethnicity:

  • Asian
  • Black/African American
  • Hispanic/Latinx
  • Multiracial or Native/Indigenous American
  • Native Hawaiian or Other Pacific Islander
  • White
  • Other
• * Relationship to Student(s):
• * Cell Phone:
• *

  School District In Which Your Student(s) Attends School:

  • Adams 12 Five Star Schools
  • Aurora Public Schools
  • Boulder Valley School District
  • Brighton 27J School District
  • Cherry Creek School District
  • Denver Public Schools
  • Jefferson County School District
  • Other
  • Private School

Student Information

You may add a maximum of 4

Student #1: Student Information

• * First Name:
• * Last Name:
• * Age: --Choose-- 10 11 12 13 14 15 16 17 18
• * Date of Birth:
• * Grade Going into in 2023/2024 School Year: --Choose-- 5 6 7 8 9 10 11 12
• * Full Name of School: (Example: DSST-Montview or Grandview High School)
• * Student Email (Parent's Email if Student doesn't one):
• * Emergency Contact Name:
• * Emergency Contact Cell #:
• Student Cell #:

Registration Type

• * New to Summer Math Bootcamp or Returning Student to Summer Math Bootcamp? --Choose-- Returning New