Holiday Robotics Registration Form

Holiday Robotics Registration Form

Please fill in the form below.
Student Name *

First Name Last Name
Date of birth *

Day Month Year
Date Date Picker Icon
Which day(s) are you registering for?
Previous robotics experience?

Yes No
Parent/guardian name *
Full name
Parent phone number *
Parent E-mail *
Emergency contact *
Name and phone number
Allergies/medical issues
Consent
By submitting this form, parents and guaridians agree they have spoken to students about:
- listening to student mentors and coaches and participating in lessons with grace and courtesy;
- abiding by the terms and conditions outlined in the Elonera Montessori School Charter of Respect.
Parents/guardians agree to:
- authorise emergency medical treatment if needed.
- commit to paying registration fees. Participation is only guaranteed once payment has been made. A link to the payment gateway will appear once the form is submitted.
- ensure students are picked up promptly at the end of sessions.
- understand that sessions are being run by experienced parent and student volunteers and while endorsed by the school are NOT an official school or OOSH activity.
Permissions

I consent for photos and video images to be taken of my child which may be used in a variety of settings including media, website, print and other.
Comments or questions:
I am paying for:

Single day camp $ 70.00 AUD

Both holiday camps (discounted) $ 120.00 AUD

Total $ 0.00 AUD
Once you click submit you will be redirected to PayPal to complete your payment (Credit Card or PayPal account accepted). Please send us a copy of your PayPal receipt as we will need payment to confirm your place.
Should be Empty:

Holiday Robotics Registration Form

Consent