Coding with Arduino Bootcamp - Wireless Technologies
June 25 - June 28, 2018
Monday - Thursday 9 a.m. - 4 p.m.
IRSC Main Campus, Fort Pierce, FL
Email address *
Child's First Name *
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Child's Last Name *
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Child's Age *
Where does the child attend school? *
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List all Parents/Guardians authorized to pick-up and drop-off your child at the LASER-TEC bootcamp
Parent/Guardian Name *
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Parent/Guardian Phone Number *
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Parent/Guardian Email Address *
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Parent/Guardian Name (2)
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Parent/Guardian Phone Number (2)
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Parent/Guardian Email Address (2)
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Emergency Contact Name *
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Emergency Contact Phone Number *
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List any additional parents/guardians authorized to pick-up & drop-off your child here. Please include telephone numbers.
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How did you learn about this LASER-TEC bootcamp? *
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Has your child previously attended any of LASER-TEC's camps? Select all that apply *
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Important Information
After the registration form is submitted, a parent/guardian will receive an email with three forms that are required to be filled out, signed, and submitted to LASER-TEC before a student is admitted to any LASER-TEC bootcamp. The completed forms should be sent to lhays@irsc.edu or mailed to:

Lauren Hays
Indian River State College,
3209 Virginia Ave, Fort Pierce, FL 34981
Brown Center for Innovation and Entrepreneurship, office Y303C

Parents, please be aware that we do not allow arrivals prior to 8:45AM as no adult supervision is provided until that time.

For your convenience, the payments can be made online.

For question, please contact Lauren Hays at 772.462.7179 or lhays@irsc.edu

A copy of your responses will be emailed to the address you provided.
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