REGISTRATION + PAYMENT

REGISTRATION FORM (PAYMENT LINKS AT BOTTOM OF PAGE)
Term: (Fall, Winter, Spring) *
Course Name: *
Specific Time / Day of Week: *
Child Name *
Child DOB *
Parent #1: Name *
Parent #1: Address *
Parent #1: Phone *
Parent #1: Email *
Parent #2: Name *
Parent #2: Address *
Parent #2: Phone *
Parent #2: Email *
Emergency Contact: Name *
Emergency Contact: Phone *
Emergency Contact: Email *
Child: Authorized drop off / pickup parent *
Child: Academic strengths *
Child: Personal interests *
Child: Would like to learn more about... *
Child: Allergies / Medical Conditions *
Child: Previous STEM / Robotics experience? *
Child: Need a laptop (Y/N) *
Additional Information: *

PAYMENT SECTION:

 

 

FALL/WINTER/SPRING COURSES

 

Per Course: $200

(per 3 month session)