DaytonaState.eduA MEMBER OF THE FLORIDA COLLEGE SYSTEM

Daytona State College prohibits discrimination and provides equal opportunity in employment and education services to all individuals without regard to age, ancestry, belief, color, disability, ethnicity, genetic information,

gender, marital status, national origin, political affiliation, pregnancy, race, religion, sex and veteran status. 25800H

DSC

2/1

6

FREE DSC SUMMER CAMPS

Get on TRACK

for College and

your Career!

Our camps include:

WHEN: WEEK 1: June 13–16, 9 a.m. to 3 p.m. WEEK 2: June 20–23, 9 a.m. to 3 p.m.WHERE: DSC’s Advanced Technology College 1770 Technology Blvd. Daytona Beach

MAXIMUM 20 STUDENTS PER CAMP PER WEEK. Spots are reserved on a first-come, first-served basis.

Limited bus transportation will be provided from Daytona State College’s campuses to camp locations.

Pick up an application online at www.DaytonaState.edu/SummerCamps, or by visiting your guidance counselor or AVID instructor.

Send applications to Cindy Bunton one of 3 ways:

Mail: 1200 W. International Speedway Blvd. Bldg. 500/Rm. 103, Daytona Beach, FL 32114 Email: Virginia.Bunton@DaytonaState.edu Fax: 386-506-3544

Engineering

3D Modeling

Interior Design

Photography

Public Safety

Architecture

POLICE

Engineering• Design objects utilizing solar power!• Assemble analog and digital electronic circuits• Build articulated structures

3D Modeling• Use 3D Modeling software to design a 3D model car! • We will print your 3D model car that you can take home

Architecture• Design your own treehouse!• Build a scale model to take home

Interior Design• Design and build your own sky-rise city apartment!• Take home a floor plan and presentation board

Public Safety• Go behind the scenes in the day of a police officer, firefighter and EMT, and become CPR-certified!* No open-toe shoes; wear long pants for leg protection; expect to get wet on fire days

Photography (Week 2 only)• Create a working box camera!• Develop B&W prints in a darkroom • Experiment with motion blurs and stop-action• Learn the basics of photo-editing and manipulation• Take home a CD of your work

DSC CTE SUMMER CAMPS • APPLICATION/REGISTRATIONDaytonaState.edu/SummerCamps Daytona State College is offering a FREE 8-day summer camp for Volusia and Flagler County high school students entering grades 9 to 12 in the Fall of 2016. CAMPS ARE FILLED ON A FIRST-COME, FIRST-SERVED BASIS AND WILL CLOSE WHEN THAT CAMP IS FULL. Students are responsible for bringing their own lunches.

(Please print):

Student name __________________________________________________________________________________ Grade in Fall 2016______________________________

Parent/Legal Guardian ___________________________________________________________________________________________________________________________

Address _________________________________________________________________ City ___________________________________________________________________

Parent/Legal Guardian email __________________________________________________________________________________ Phone______________________________

Emergency Contact Name (if other than Parent/Legal Guardian) _______________________________________________________________________________________

Emergency Contact Phone (if other than Parent/Legal Guardian) _______________________________________________________________________________________

T-shirt size (choose one, all sizes are “adult”): XS ❑ S ❑ M ❑ L ❑ XL ❑ XXL ❑

I would like to participate in the following camps. I understand that once a camp is confirmed for that week, it cannot be changed. (See flyer on reverse side for camp descriptions.)

WEEK 1: June 13-16, 9 a.m. to 3 p.m. (choose only one) – ❑ Engineering ❑ 3D Modeling ❑ Interior Design ❑ Architecture ❑ Public Safety

WEEK 2: June 20-23, 9 a.m. to 3 p.m. (choose only one) – ❑ Engineering ❑ 3D Modeling ❑ Interior Design ❑ Architecture ❑ Public Safety ❑ Photography

DSC Travel Release (Limited bus transportation will be provided from Daytona State College campuses to the camp locations.)I hereby release from liability and hold Daytona State College harmless for any and all claims and causes of action that might be brought by me or my parents or dependents for loss of property, personal injury or death sustained by me arising out of any travel or activity conducted by or under the control of the College. It is understood that the College as used herein shall include the employees, administrators, agents and Board of Trustees of the College.

________________________________________________________________________ _______________________________________ ____________________________Parent/Legal Guardian Signature Student Signature Date

Photo ReleaseI give permission and consent for ___________________________________ to have his/her picture taken during camp session activities. (print minor student’s name)

I further give permission and consent that any such photographs may be published and used by Daytona State College and its agents to illustrate and promote the camp experience.

Parent/Legal Guardian Signature ______________________________________________________________________ Date______________________________

Medical ReleaseDaytona State College requires that the following Emergency Medical Release Form be signed by the parent or legal guardian for each child attending.

In an emergency requiring medical attention, for which I shall pay and not hold Daytona State College responsible, I authorize Daytona State College representatives to take my child to the nearest hospital. I also authorize minor first aid as needed for my son/daughter.

________________________________________________________________________ _____________________________________________________________________Print Name of Parent/Legal Guardian Parent/Legal Guardian Signature

Does your child have any medical problems of which we should be aware? ❑ YES ❑ NO If “YES”, what? _______________________

Is your child allergic or sensitive to any drugs? ❑ YES ❑ NO If “YES”, what?_____________________________________________________

Is your child taking any medications at the present time? ❑ YES ❑ NO If “YES”, what? _________________________________________

Is your child allergic or reactive to insect bites or stings? ❑ YES ❑ NO If “YES”, what? _________________________________________

________________________________________________________________________ _______________________________________ ____________________________Parent/Legal Guardian Signature Student Signature Date