2020 SCOPES Summer Program Registration Form

Camper Name Camper Name First Last
Camper Nickname

If your child prefers to go by a different name other than his or her given name, please list here.
Camper Grade in Fall 2020

Please select the grade your camper will be entering in Fall 2020.
Camper Birthday Camper Birthday / MM / DD YYYY
Camper Gender
Camper T-Shirt Size
Camp Weeks

Camp Weeks Microscope - June 15 to 19, $295 Microscope - June 22 to 26, $295 Microscope - July 6 to 10, $295 Microscope - July 13 to 17, $295
Camp Weeks

Camp Weeks Kaleidoscope - June 15 to 19, $295 Kaleidoscope - June 22 to 26, $295 (Sold Out - Waitlist Only!) Kaleidoscope - July 6 to 10, $295 (Sold Out - Waitlist Only!) Kaleidoscope - July 13 to 17, $295 (Sold Out - Waitlist Only!)
Camp Weeks

Camp Weeks Telescope - June 15 to 19, $295 Telescope - June 22 to 26, $295 Telescope - July 6 to 10, $295 Telescope - July 13 to 17, $295

Please choose additional services needed:
	Telescope - June 15 to 19, $295	Telescope - June 22 to 26, $295	Telescope - July 6 to 10, $295	Telescope - July 13 to 17, $295
June 15 to 19	June 15 to 19Telescope - June 15 to 19, $295	June 15 to 19Telescope - June 22 to 26, $295	June 15 to 19Telescope - July 6 to 10, $295	June 15 to 19Telescope - July 13 to 17, $295
June 22 to 26	June 22 to 26Telescope - June 15 to 19, $295	June 22 to 26Telescope - June 22 to 26, $295	June 22 to 26Telescope - July 6 to 10, $295	June 22 to 26Telescope - July 13 to 17, $295
July 6 to 10	July 6 to 10Telescope - June 15 to 19, $295	July 6 to 10Telescope - June 22 to 26, $295	July 6 to 10Telescope - July 6 to 10, $295	July 6 to 10Telescope - July 13 to 17, $295
July 13 to 17	July 13 to 17Telescope - June 15 to 19, $295	July 13 to 17Telescope - June 22 to 26, $295	July 13 to 17Telescope - July 6 to 10, $295	July 13 to 17Telescope - July 13 to 17, $295

Parent's Name Parent's Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent's Email
Parent Primary Phone Parent Primary Phone - ### - ### ####
Parent Secondary Phone Parent Secondary Phone - ### - ### ####
Furman Employee
How did you hear about SCOPES?
Please Specify
If paying by credit card, please contact our office at 864-294-2390 to provide your credit card information. Payment information must be received within 7 days or reservations will be released.

If paying by check, please mail full payment to Furman University, Attn: Scopes Program, 3300 Poinsett Highway, Greenville, SC 29613.

Payment Method
Registration Form submitted by:

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Full Name

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