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2024 Math & Movement Mini-Academy Registration

for rising 4th-6th grade students


The Math & Movement Mini-Academy session for rising 4th- 6th grade students will take place on Tuesday, June 11, 2024, from 1:00 - 4:00 pm. This Mini-Academy will take place at the MC-100 building on ORAU's campus.

Registration Deadline:  May 31, 2024

If you are registering more than one child, please submit a separate registration for each child.


I would like to register my child for the Math & Movement Mini-Academy.
Student Information
First Name:
Last Name:

Please provide the preferred first and last name for your student's name badge.

What grade level is your student going into next school year (2024-2025)?
Please indicate the rising grade level of your student.
Parent/Guardian Information
Please use this format for phone number: 123-456-7890
Parent/Guardian First Name:
Parent/Guardian Last Name:
Parent/Guardian Phone Number:
Parent/Guardian E-mail Address:
School Information
School Name:
School City:
School State:

What grade did your student receive in math on their last grade report?

Grades help us to know how a student is doing in school which aids us in planning the Academy's activities.
Other comments?

Demographics

The following demographic data is used only for ORISE program participant recording.

Is the student a U.S. Citizen?
If no, what is student's citizenship?
Gender
Race
Ethnicity
Parental Consent
Please complete and upload the Parental Consent Form and upload the front and back of your insurance card. You can access the form at this link.
Page one of Parental Consent Form
Page two of Parental Consent Form
Front of Insurance Card
Back of Insurance Card

When you hit SUBMIT, you should receive a confirmation screen and email (if email address was provided).

If you do not receive a confirmation screen, please review the application for any red error messages and correct/complete all entries and hit SUBMIT again.

For technical assistance, please contact us at K12@orau.org.


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