Ck Registration Form

CK REGISTRATION FORM SESSION III GRADES 7-9----July 10-16, 2016

Name ______Grade in 2015-2016______DOB______Boy ____ Girl ____

Name you go by ______Roommate preference (name) ______

T-Shirt Size: (Adult sizes) Small ______Medium ______Large ______X-Large ______

Address ______City______State ______Zip ______

School ______Email address ______Number of years at CK ______

Parent/Guardian 1 (name) ______work (_____) ______Cell (____) ______

Parent/Guardian 2 (name) ______work (_____) ______Cell (____)______

Parent/Guardian 1 Employment______Parent/Guardian 2 Employment______AM Classes (Pick your top four) PM Classes (Pick your top four)

______Archetypes in Fear ______ACT Math Prep ______Chemistry of Food ______American Sign Language ______Cool Cards—Bridge Style ______Beginning Guitar

______Digital Photography ______Chopped II, CK Style ______Mathematical Free-for-All ______CK News

______Memory Pathways ______Games are Always Fun

______Mock Trial ______Mind Games ______Painting from Scratch ______Philosophy for All

______Ready, Set, ACTion ______Sneak Peek at the World of Medical Sciences

______The Ancient World ______The World of Harry Potter and Mythology

______The Art of Persuasion ______Wanted: Poets and Dreamers and Debate

______Vet for a Week

Fees include basic class materials, video, recreational activities, T-shirt, evening activities, and room and board for five days. Additional lab fees may be charged for some classes requiring specific supplies. Lab fees, if applicable, will be assessed after course enrollment is confirmed.