Individual Registration

Please enter information in the form below to process registration for event Coding Camp.

Child and Family Info

Please select one program per week. Coding, Robotics, Game Design, and AMC programs require enrollment for three consecutive weeks. Lunch, Bus, and Extended Hour apply only to the selected week. If your child is not attending a particular week, select Not Attending as the program.

The Child's First Name *

The Child Last Name *

The Parent 1 First Name *

The Parent 1 Last Name *

The Parent 2 First Name

The Parent 2 Last Name

Address *

City *

Zip *

State *

Phone 1 *

Phone 2

Email 1 *

Email 2

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Phone *

Grade In Sep *

Age *

Food Allergy *

Yes

No

Food Allergy Details

Comment

Week 1 Registration(July 5 to July 9)

Week1_Program

Week1_Lunch

Lunch($75)

No Lunch

Week1_Bus

BUS ($185)

NO BUS

Week1_Extended_Hour

YES($75)

NO

Week 2 Registration(July 12 to July 16)

Week2_Program

Week2_Lunch

Lunch($75)

No Lunch

Week2_Bus

BUS ($185)

NO BUS

Week2_Extended_Hour

YES($75)

NO

Week 3 Registration(July 19 to July 23)

Week3_Program

Week3_Lunch

Lunch($75)

No Lunch

Week3_Bus

BUS ($185)

NO BUS

Week3_Extended_Hour

YES($75)

NO

Week 4 Registration(July 26 to July 30)

Week4_Program

Week4_Lunch

Lunch($75)

No Lunch

Week4_Bus

BUS ($185)

NO BUS

Week4_Extended_Hour

YES($75)

NO

Week 5 Registration(Aug 2 to Aug 6)

Week5_Program

Week5_Lunch

Lunch($75)

No Lunch

Week5_Bus

BUS ($185)

NO BUS

Week5_Extended_Hour

YES($75)

NO

Week 6 Registration(Aug 9 to Aug 13)

Week6_Program

Week6_Lunch

Lunch($75)

No Lunch

Week6_Bus

BUS ($185)

NO BUS

Week6_Extended_Hour

YES($75)

NO

By registering for this event, I accept Terms and Conditions