MX Camp Registry - STUDENT INFORMATION FORM
**If there are siblings, a separate form entry is required for each**
**A separate entry for each week per camper**
Mathobotix OpenTechLabs
Camp Session #
Please select one. Please note Codologie and Gamologie camps are available to 3rd grade and above.
Camp Location
Camp Type (Learning Platform/Time Format)
Buildologie, Codologie, Gamologie, Etc
Student Grade
Student First Name
Your answer
Student Last Name
Your answer
Student Gender
Mother/Guardian First Name
Your answer
Mother/Guardian Last Name
Your answer
Father/Guardian First Name
Your answer
Father/Guardian Last Name
Your answer
Contact eMail
Valid eMail ID required
Your answer
Preferred Phone
Preferred Phone
Your answer
Alternate Phone
Phone
Your answer
Camp Fee
Starting at $325.00
Payment Status
City
Enter the name of the City (Street Address Not Required)
Your answer
Zip
Your answer
Health Concerns
Health Concerns, Medications, and Special Educational Needs if any. If nothing to report enter "None"
Your answer
Relevant prior Mathobotix Buildologie/Codologie/Gamologie or other robotic/programming experience
Enter any other comments, prior Mathobotix Buildologie/Codologie/Gamologie or other robotic/programming Experience, and any info regarding Siblings, Grouping Preferences, Drop-off/Pick-up by a designated person, etc.
Your answer
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