Chemistry Camp

*Required Fields

PARTICIPANT INFORMATION:

*First Name

Preferred Name (used in official communications)

*Last Name

Student Cell Phone

IMPORTANT NOTE: Please make sure to enter the email addresses accurately, as we use email to send program information, confirm enrollment, cancellation notices, and other important information.

*Student Email Address

*Mailing Address

Country

Street

City

Region

Postal Code

*Birthdate

*Please note, if you are unable to select your current year in school for the 2025-2026 school year, you are not eligible to attend this camp.

*Grade of camper during the CURRENT 2025-26 school year:

Are you a child of a South Dakota Mines alum?

Alumni name used at Mines graduation:

Year of Mines graduation:

What Mines degree was awarded:

Hispanic:

Yes

No

*Sex (as assigned at birth)

Female

Male

*T-Shirt Size (Adult Uni-Sex Sizes)

*School

We cannot guarantee to meet dietary needs if they are not listed here.

List any Dietary Allergies:

*Do you require any accommodations? For example, elevator, ramps, etc.

Yes

No

If yes, please explain.

How did you hear about South Dakota Mines camps?

*I have taken or am taking a high school Chemistry class.

Yes

No

*Please list any programming languages you have used:

*STUDENT INTERESTS STATEMENT:

Camper, in your own words, please share a bit about yourself and your interests. Tell us why you're interested in attending this camp, what you hope to learn while you're here, and include any STEM classes you've taken that relate to the camp.

*TEACHER INFORMATION:

The Mining and Explosives camp will require a teacher recommendation, due by March 30th. Please provide contact information for a teacher and we will email them the recommendation request. You will be notified via email once the recommendation has been received.

The Adventures in Aviation camp will require a teacher recommendation, due by March 30th. Please provide contact information for a teacher and we will email them the recommendation request. You will be notified via email once the recommendation has been received.

*Teacher's Name

*Teacher's Phone

*Teacher's email:

*Confirm email:

*PARENT/GUARDIAN INFORMATION:

*Parent/Guardian First

*Parent/Guardian Last

*Relationship

*What is the highest level of education completed by either parent/legal guardian?

IMPORTANT NOTE: Please make sure to enter the email addresses accurately, as we use email to send program information, confirm enrollment, cancellation notices, and other important information.

*Parent Email Address

*Parent Cell Phone

PAYMENT

*A $100 refundable deposit is required at the time of submission and will be refunded if not accepted. If accepted to the camp, and the student does attend, the money will also be refunded.

Summer Camps Payment Due

Amount Due
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Amount Due

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Enter Code for Approved Scholarship/Fee Waiver

CANCELLATION POLICY:

I understand that a 30-day notice is required for all camps.

*I have read and agree to South Dakota Mines Camp Cancellation Policy as stated above.

Yes

MEDIA AUTHORIZATION:

By completing payment/registration, I hereby authorize the South Dakota School of Mines & Technology, hereafter referred to as “University”, to publish photographs or video taken of me for use in the University’s print, online, and social media marketing materials, as well as other University publications. Should you choose to opt out of the media release, please email Alyssa Shipper at Alyssa.Shipper@sdsmt.edu.

*BEHAVIOR POLICY:

In the best interest and safety of camp participants, South Dakota Mines has a two-strike policy regarding inappropriate behavior. First incident results in parent and camper notification. Second incident results in expulsion from the camp with no refund.

The code of conduct includes, but is not limited to:

-Treating staff and other students with respect.

-Being punctual and alert during the entirety of the camp schedule.

-Participating to the best of your ability in the camp activities.

-Respecting facilities and equipment.

-Not using foul language or gestures.

-Following the directions of camp support staff.

-Not using cell phones or other devices during camp activities (unless in case of emergency).

-Wearing appropriate clothing for activities as directed, including pants and closed-toed shoes.

-Students are encouraged to get to know and engage other students but should refrain from conversations that distract from camp activities.

*I have read and agree to South Dakota Mines Camp Behavior Policy as stated above.