Coding with Arduino Bootcamp - Game Programming
November 6 - December 18, 2019
5:30 - 7:30 p.m.
IRSC Main Campus, Fort Pierce, FL
Child's First Name
Child's Last Name
Where does the child attend school?
List all Parents/Guardians authorized to pick-up and drop-off your child at the LASER-TEC bootcamp
Parent/Guardian Phone Number
Parent/Guardian Email Address (if different from e-mail provided above)
Parent/Guardian Name (2)
Parent/Guardian Phone Number (2)
Parent/Guardian Email Address (2)
Emergency Contact Name
Emergency Contact Phone Number
List any additional parents/guardians authorized to pick-up & drop-off your child here. Please include telephone numbers.
How did you learn about this LASER-TEC bootcamp?
Email from LASER-TEC
K12 school teacher
Has your child previously attended any of LASER-TEC's bootcamps?
If "Yes" to the previous question, please list the camps your child has attended:
After the registration form is submitted, you will receive an email with the link for payment as well as three forms that are required to be filled out, signed, and submitted to LASER-TEC before any student will be admitted to the LASER-TEC bootcamps. Please check your Junk or Spam folder if you do not see an e-mail from the LASER-TEC team in your primary inbox.
For question, please contact the instructor, Will Keiser, at 772.462.7074 or
A copy of your responses will be emailed to the address you provided.
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