ProBots Ottawa 2019 Summer Camp Registration
Consent of Participation
I acknowledge that there are risks in any program. I declare that I have accurately disclosed all information regarding
my daughter/son's physical, mental, or medical conditions. I under stand that ProBots Ottawa has tried to create a safe
and controlled environment for participation. I waive the rights of my daughter/son to damages or other costs in the event an injury is caused due to participation here.
Email address *
I want to register for: *
Required
Enter your Child's First and Last Name *
Address *
Sex *
Email Address *
Home phone *
Birthdate (Month/Day/Year) *
Secondary Contact Number *
Name of Parent or Guardian *
Relationship *
Required
Learning or Behavioural Concerns (IEP, ADHD, ETC, NONE) *
I have read the Consent of Participation *
Required
May we use your child's photo without names *
Required
Please send future updates *
Required
Select Payment method (We accept VISA and Mastercard) *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service