Flathead Valley Online Registration for Code Girls United 2020 - 2021
Sign in to Google to save your progress. Learn more
Code Girls United year long program is open to girls who are between 10-14 years old (girls who turn 15 prior to August 1, 2021 are not eligible) .  Exceptions to age up for 2020-2021 are being taken due to Covid  from 2020.  Please note if your child will be 15 prior to August 1, 2021. *
Additionally, each participant will receive a codegirlsunited gmail account to use during the program.  Participants are required to do their team projects on a team account established by Code Girls United.  Parents/Guardians are needed to help facilitate work completed outside of our meetings for team projects.  
Are you willing to purchase, or do you have access to an android phone or tablet?  The cost is approximately $30 for an unlocked, non-networked phone.     *
Participants First Name *
Participants Last Name *
Participants Birth Date *
MM
/
DD
/
YYYY
Participants Address *
Participants School
Parent/Guardian *
Parent/Guardian's Phone *
Parent/Guardian's Email *
Is there anything the Parent/Guardian would like to tell us about your child? *
Does the participant have access to a computer with a wifi connection that they can access on a weekly basis (home, library, etc)? *
Participant:  Why do you want to be a Code Girl? *
Participant:  Tell us 3 things about yourself? For example, what is your favorite school subject, do you volunteer for anything, what do you like to do   for fun, do you do any sports or other extracurricular activities? *
Participant:  What kind of puzzles do you like to do? Check all that Apply. *
Required
Participant:  What is your experience with coding?  Check all that Apply. *
Required
Participant:  Tell us about team you have been on and what you liked and didn't like. *
Participant:  Will you make sure to be available and give your contact information to your other team members? *
Participant:  I agree to the following:  I will not use my phone during Code Girls United sessions unless I am skyping/facetiming someone on my team, or testing my app.  I will come to each session ready to work.  If I can’t make a session, I will let one of the mentors know.  I will be respectful of everyone’s input.   I will not criticize, as all input is welcome.  I understand that the computers and devices (phones and tablets) are for work, coding, designing, etc.  I will not use the computer or any device in the classroom to communicate with outside friends, nor perform unrelated tasks.  I commit to pay attention to what is happening in my group, in the classroom, and to anyone who may be addressing the group. I commit to doing my homework,  if the assignment is not clear, I will ask a mentor. *
Parent/Guardians:  Are you willing to arrange transportation to and from our weekly meetings? *
Parent/Guardians:  Are you willing to provide volunteer support (2 hours per year) for Code Girls United? *
Parent/Guardian:  I will help my child’s team with the business plan and videos, in the form of coordination or any assistance I can provide.I will remind my child of the student guidelines, in particular, no phones and focusing in class.  I will read and respond to emails in a timely manner. *
PHOTO/VIDEO AND GENERAL RELEASE FORM: I hereby give permission for images of my child, captured through video, photo and digital camera, to be used solely for the purposes of Code Girls United promotional material and publications, and waive any rights of compensation or ownership thereto.  Additionally, Code Girls United retains ownership thereto of all projects and materials developed.   I hereby agree to release and hold harmless Code Girls United, its, officers, employees, volunteers, committees and boards, from and against any and all liability, loss, damages, claims, or actions (including costs and attorneys fees) for bodily injury and/or property damage, to the extent permissible by law. This indemnification and hold harmless agreement shall include indemnity against all costs (including without limitation, reasonable attorney's fees and court costs), expenses and liabilities incurred in or in connection with any such claim or proceeding brought thereon and in defense thereof.  I have read and understand this release, indemnification and hold harmless form. I voluntarily sign it and hereby give permission to the Code Girls United for emergency transportation and/or treatment in the event of illness or injury. I hereby accept responsibility for the payment of any emergency transportation and/or treatment. I further certify that my child is in good physical condition, and has no medical or physical conditions that would restrict his/her participation in this activity or program.          Agree by  Signing Your Name and Date Electronically below. *
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This content is neither created nor endorsed by Google.