View/Download the camp flier and application

When: You can sign up for one of these three
weekends:
July 16-17
July 23-24
July 30-31
Who: for students ages 12-14
Cost: $50
SPACE IS LIMITED! Registration is required.
To receive camp registration forms by email please contact Wendy Lutzke
[email protected] or call 920-684-0218 x 115
You can also pick up the forms at the museum’s admission desk between 9-5 every day.
What will you do?

Work in a small team to build and pilot an ROV (remotely
operated vehicle).

Participate in activities related to physics, engineering,
underwater archaeology, and forensic science.

Work with our local FIRST Robotics Competition teams
STEMpunk and Droid Rage for a fun, interactive experience!
Out on the water!
Weather permitting, the camp experience will
include a trip out onto Lake Michigan in order to
view shipwrecks in the proposed NOAA National
Marine Sanctuary.
Wisconsin Maritime Museum
ROV Summer Camp 2016 Application Form
Name of student:
___________________________________________________
Age at time of camp: __________
Mailing Address: _______________________________________________________
City _______________________ State _______ Zip Code _____________________
Email: ________________________________________________________________
Best phone contact number: ______________________________________________
Please choose the weekend you’d like to participate in order of preference by writing 1,2, or 3 in the
blank next to each date. Because space is limited you might not get your first choice. We will inform you
which weekend you are registered for.
July 16-17 ___________
July 23-24 ___________
July 30-31 ___________
Camp hours will be 9-4 on Saturday and 12-5 on Sunday.
Saturday lunch, a Sunday snack, and water are provided. Students may bring an additional beverage of
their own. Please let us know of any food allergies your child has by writing them here:
____________________________________________________________________
Please return this form, the signed waiver, and your $50 payment (check or credit card).
Please make check payable to:
Wisconsin Maritime Museum ROV Summer Camp
Attn. Wendy Lutzke
75 Maritime Drive
Manitowoc, WI 54220
Or pay by credit card:
___ Mastercard
___ Visa ___ Discover
Credit Card # ________________________________________
Security code _____
Exp. Date ________ Signature ____________________________________
WAIVER AND RELEASE OF LIABILITY
I permit my child to participate in the following described activities in July 2016
during the ROV Summer Camp:
SCIENCE ACTIVITIES RELATED TO BUILDING A REMOTELY
OPERATED VEHICLE AND PILOTING IT WHILE STANDING
NEXT TO A SMALL ABOVE GROUND POOL; RIDING ON A
BOAT WITH A USCG LICENSED CAPTAIN ALONG THE LAKE
MICHIGAN SHORELINE.
I CERTIFY THAT I AM AWARE THAT THESE ACTIVITIES INVOLVE A CERTAIN LEVEL OF
RISK NOT NORMALLY ENCOUNTERED, AND THAT I VOLUNTARILY ASSUME ALL RISKS
ASSOCIATED WITH SUCH ACTIVITY.
AS CONSIDERATION FOR MY CHILD BEING PERMITTED TO PARTICIPATE IN THIS
ACTIVITY, I HEREBY VOLUNTARILY RELEASE THE WISCONSIN MARITIME MUSEUM AND
ANY AND ALL OF THE ORGANIZATION’S TRUSTEES, OFFICERS, EMPLOYEES, AGENTS &
REPRESENTATIVES FROM ANY CLAIMS FOR PERSONAL INJURY OR PROPERTY DAMAGE
ARISING OUT OF OR CONNECTED WITH MY CHILD’S/CHILDREN’S PARTICIPATION IN SAID
ACTIVITY, WHETHER SUCH INJURY OR DAMAGE WAS CAUSED BY NEGLIGENCE OR
OTHERWISE, & I HEREBY VOLUNTARILY WAIVE MY RIGHT TO MAKE A CLAIM AGAINST
OR SUE FOR SUCH INJURY OR DAMAGE.
I have carefully read this Release of Liability Agreement & fully understand its contents. I am
aware that by signing this document, I am releasing from liability the Wisconsin Maritime
Museum and its trustees, officers, employees, and agents, jointly and severably; I sign this
document of my own free will.
_____________________________
[Signature]
_____________
[Date]
____________________________
Please print
Child’s Name (Please Print)
Child’s Age
________________________
_________
ROV Summer Camp Waiver 2016 –Wisconsin Maritime Museum