Parent/Guardian First & Last Name (Your Name) *

Email *

Phone Number *

Would you like to receive a text message when a new course is open for registration? *

Yes

You agree to receive automated reminders and promotional messages from Young Innovators Robotics Lab. You also agree to our Terms & Conditions and Privacy Policy. This agreement isn't a condition of any purchase. Msg & Data rates may apply. Reply STOP to end.

Student Info

Student's Full Name (First and Last) *

Student's Age *

Course Info

Start Date of Course or Camp *

Photography & Video Consent Form

Photos of participants are often taken to document and promote our programs and services. These images may be used in video footage, advertisements, brochures, publications, audio-video presentations, displays, social media sites, and the Young Innovators Robotics Lab website. We will not release any names or give any other information out regarding the identification of individuals in the photos without their prior consent. This consent form is to obtain permission to use your son/daughter’s image ONLY.

I give permission for the Images of my child to be used to promote Young Innovators Robotics Lab Programs. *

Yes

________________________________________________________________________

Do you want to register another kid? *

Yes

Please sign to acknowledge that the details you entered above are correct and complete. *

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