Robotics for Kids Registration Form
200 Lanidex Plaza
Parsippany, NJ 07054
(973) 434-7080
info@hadoopexpress.com

Fill this form and submit online. You may be required to sign on a hard copy of the form when you arrive for your first class. You will receive an email with options to pay by CHECK/ CREDIT CARD/ CASH online or at our facility on your first day of attendance.

(Email address below will be use to send you a copy of your response you enter in this form).

Email address *
Robotics at Hadoop Express
Child's Detail :
NAME (CHILD 1) *
Your answer
AGE (CHILD 1) *
Your answer
NAME OF SCHOOL (CHILD 1 ) :
Your answer
Registering Child1 For Which Program (Pick one) *
Day and time you prefer. These are choices for the 200 Lanidex Plaza, Parsippany location *
Do you wish to attend at the following location(we have started offering this option and will contact you for timings)?
NAME (CHILD 2 IF ANY)
Your answer
AGE (CHILD 2 IF ANY )
Your answer
NAME OF SCHOOL (CHILD 2 IF ANY )
Your answer
Registering Child 2 For Which Program, if any
Any medical condition / allergy for child 1 ?
Your answer
Any medical condition / allergy for child 2 ?
Your answer
PARENT/GUARDIAN'S NAME *
Your answer
PARENT/GUARDIAN'S PRIMARY PHONE *
Your answer
PARENT/GUARDIAN'S SECONDARY PHONE
Your answer
ADDRESS
Your answer
EMERGENCY CONTACT NAME *
Your answer
EMERGENCY CONTACT PHONE *
Your answer
YOUR PREFERENCES FOR ALERTS
PERMISSION FOR PHOTOS/ VIDEOS : We demonstrate your child's good work and progress by sharing photos and videos may be used for advertisement or marketing purposes but are not sold or distributed without your knowledge . Do you grant permission for use of pictures and videos of your child(ren)? Your answer does not affect your child(ren)'s admission. *
TERMS AND CONDITIONS :
Hadoop Express does not guarantee or warranty that the offered training will meet your requirements and/or class methods will be error free. Hadoop Express should not be considered to conform to any standard or qualification approved by any government or private agency. Student parents or guardians may not use or transmit Hadoop Express material , methodologies or content for any new or existing business venture for a period of 5 years after enrolling and 3 years after completion or withdrawal from Hadoop Express courses.
PARENT AGREEMENT :
I am enrolling my above mentioned child (ren ) at Hadoop Express and acknowledge that I have received and reviewed tuition policy and general guidelines . In addition, I have read and agree to the following :
1. Hadoop Express shall not be responsible in case of sickness or injury of the enrolled child(ren) while in attendance at the facility or in transit to or from the facility.
2. I also agree to abide by all terms, policies & procedures of Hadoop Express that are communicated to me in this form or by any other means.
Parent/Guardian Signature :
I understand Hadoop Express policies and procedure. I have the relevant contact information to seek additional guidance. I am providing my Signature and Date below as confirmation of terms and conditions.
Signature : *
Your answer
Date : *
Your answer
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