Coding with Arduino Bootcamp - Visible Light Spectrum
Wednesday Evenings
January 22 - February 26, 2020
5:30 - 7:30 p.m.
IRSC Main Campus, Fort Pierce, FL
For more information, visit www.laser-tec.org/bootcamps
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 (if different from e-mail provided above)
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Parent/Guardian Name (2)
Your answer
Parent/Guardian Phone Number (2)
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Parent/Guardian Email Address (2)
Your answer
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.
Your answer
How did you learn about this LASER-TEC bootcamp? *
Required
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:
Your answer
Important Information
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 wkeiser@irsc.edu
A copy of your responses will be emailed to the address you provided.
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