Technology Camp Registration Form
A $1000 non-refundable deposit must be paid when submitting the application.
Note: The deposit will be credited toward the total cost for this camp.
Name *
First Name, Last Name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Dining preference *
Health Condition *
Email Address *
Your answer
Phone Number *
Your answer
Contact Address *
Your answer
Guardian's Info
Guardian's Name *
Your answer
Relationship to Participant *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Deposit Payment
A $1000 non-refundable deposit must be paid when submitting the application.
Note: The deposit will be credited toward the total cost for this camp.

Please choose to send a check or provide credit/debit card information.
If you choose to pay with your check:

Check Payable to: World Journal SF LLC
Address: 231 Adrian Road, Millbrae, CA 94030
Attn: Peggy
Payment Options *
Credit/Debit card type
Credit Card Number
Your answer
Name on the card
Your answer
Expiration Date
Your answer
Security code
Your answer
Survey
How did you hear about Technology Camp? *
Required
Have you ever heard about Robotics Camp? *
If yes, how did you hear about Robotics Camp?
Have you ever heard about Basketball Camp? *
If yes, how did you hear about Basketball Camp?
Comment
Your answer
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