Summer Camp Scholarship Eligibility: Female-identifying or gender non-binary student Rising 6th-9th grader (ages 11-15) Resident of the City of Miami. Check your address here to make sure you live within the City of Miami. Summer Camp Application "*" indicates required fields Which camp location and dates are you applying for?***Select one from below**Coconut Grove - July 17th-21st (8:30am-4pm) @ MDC Gibson Education CenterLittle Havana - July 17th-21st (8:30am-4pm) @ MDC Eduardo J. Padrón CampusLiberty City - July 24th-28th (8:30am-4pm) @ MDC Carrie P. Meek Entrepreneurial Education CenterSecond Choice Camp Location/DatesIf your first camp session choice is full, you can select a second choice here to improve your chances for being accepted.**Select one from below**Coconut Grove - July 17th-21st (8:30am-4pm) @ MDC Gibson Education CenterLittle Havana - July 17th-21st (8:30am-4pm) @ MDC Eduardo J. Padrón CampusLiberty City - July 24th-28th (8:30am-4pm) @ MDC Carrie P. Meek Entrepreneurial Education CenterParent/Guardian InformationName* First Last Email* Mobile Phone*Home Address*This address should be the student's primary address. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian Primary Language* English Español Kreyòl Other Other Primary Language* Does your child qualify for free or reduced lunch?* Yes No Student InformationStudent Name* First Last Student Grade*This camp is only open to students in rising grades 6-9.**Select below**Rising 6th graderRising 7th graderRising 8th graderRising 9th graderStudent School in the Fall* Is student's school a Title I school?* Yes No Not Sure Student Gender*This camp is only open to students who are female identifying or gender non-binary.**Select below**FemaleTransgender FemaleNon-binaryPrefer to Self-DescribePrefer to self-describe as...* Student Race/Ethnicity?*Select all that apply. American Indian or Alaskan Native Asian or Asian American Black or African American Hispanic or Latinx Native Hawaiian or Other Pacific Islander White or Caucasian Mixed Race Student's Coding Experience (optional)Check all languages below with which you have some experience. (No prior experience is required.) Scratch Python JavaScript HTML CSS App Lab MIT App Inventor None of the above Student Interest (optional)Use the space below to write a short paragraph explaining your interest in taking part in Code/Art's summer creative coding program for girls. Student t-shirt size*Pick a size from our remaining sizes.**Select below**Adult MediumAdult LargeAllergies and Dietary Restrictions*We want to ensure the safety and well-being of all our camp participants. As breakfast and lunch will be provided during the camp, it is crucial for us to be aware of any food allergies, dietary restrictions, or special requirements your child may have. Does your child have any allergies/dietary restrictions we should be aware of? Yes No Does your child have any food allergies or sensitivities? If yes, please list them below and specify the severity of the reaction (mild, moderate, severe) and any relevant symptoms.*Does your child require an EpiPen or any other emergency medication for their allergies? If yes, please specify.*Does your child have any dietary restrictions or preferences (e.g., vegetarian, vegan, gluten-free, lactose intolerant, religious restrictions)? If yes, please specify.*Are there any additional precautions or information we should be aware of regarding your child's allergies or dietary needs? Please provide details.*Additional Terms and FeedbackMedia Release*By attending the Code/Art Camp, I authorize Code/Art to film and/or photograph my child and any projects created by them during their time in the program. I agree Attendance Requirement*I agree to ensure that my child attends all five (5) days of camp and finishes all projects in order to receive her certificate of completion at the end of the week. I understand that I must notify Code/Art if there is an emergency requiring my child to miss part of camp. If my child has an unexcused absence, Code/Art reserves the right to give my child's spot to another student from the waitlist. I agree How did you hear about this program?***Select below**Code/Art EmailSocial MediaA Friend/Word of MouthA TeacherCommunity CenterOtherOther way you heard about this program?* CommentsThis field is for validation purposes and should be left unchanged.
