Health & Parent Consent Form

To complete your camp registration, please fill out this Health & Parent Consent Form in its entirety. You will need to fill out a separate form for each child registering for camp. If you have questions about this form, please contact or call 515-274-6868 ext. 222.

Fields marked with an asterisk [*] are required.

Camper Information

In case of emergency, the Science Center of Iowa will take your child to Mercy Hospital in downtown Des Moines. If you do NOT want them to go to Mercy, where do you want them sent?

I understand photographs may be taken of my camper for future SCI marketing purposes, and I give consent for my camper’s photos to be used.

Camps Attending

Please select all of the camps your child will be attending from the list below.

Parents must agree to the following to finalize camp registration.

SCI camps are taught by college students or recent graduates that have been studying Education and/or Science.

SCI campers will be learning about the topic of the camp title. If there is time to explore the rest of the museum, then the camp will do so. Otherwise, the campers will be focused on learning the subject at hand.

I understand that SCI is not responsible for personal items my camper brings such as electronic devices, games, cell phones, money, etc.

I am aware of the camp’s starting and ending times (AM Camp 9:00 AM – 12:00 PM and PM Camp 1:00 PM – 4:00 PM) and will drop off and pick up promptly. I realize that if my child arrives late, they may miss their fieldtrip and will be placed with another camp for that day.

I am aware of what time extended care starts and ends (Before Care 7:30 AM – 9:00 AM and After Care 4:00 PM – 5:30 PM) and will drop off and pick up promptly.

My child is in 5th-8th grade and can sign themself in and out of camp. If yes, you must indicate where your camper is to wait for you for pick-up:

For those 5th-8th graders allowed to sign themselves out of camp, they must go directly to the designated pick-up location listed above. They are not allowed to explore SCI after camp unless accompanied by an adult.

Other Information

Is child your attending a full-day of camp?

I understand and agree that the above information is correct.