Technocopia Youth Registration
A deposit is required to successfully reserve a student's seat in any class. To complete enrollment in any class parents/guardians must also complete this registration form which collects important information regarding you and your child.

Information submitted through this form will remain private and may only be viewed by Technocopia staff. Please list multiple entries in a vertical fashion.

Student Name (Last, First) *
Your answer
Date of Birth(s) (dd/mm/yy) *
Your answer
Please review our Policies and Procedures located at the link below:
Parent(s)/Guardian(s) Name(s) *
Your answer
Email *
Your answer
Primary & Secondary Phone Number *
Your answer
Home Address *
Street, City, State, Zip
Your answer
Emergency Contact
In the event of an emergency, the first person we should notify.
Name *
Your answer
Relation *
Your answer
Emergency Contact Phone Number *
Your answer
Allergy Information *
Your answer
Program Titles. Please list classes, workshops or vacation weeks you are signing up for. *
Your answer
Building and Grounds. This indicates your conditional consent regarding the student(s) leaving the Technocopia facility. *Please note that all students aged 12 or below may not leave the facility unless attended by a staff member, parent/guardian, or additional adult(s) referenced below. *
Media Release. Technocopia uses several forms of media for promotional and educational purposes such as photo, video and audio. From time to time, members or students may be asked to be recorded or be made aware that a recording is taking place. Recordings may be published publicly on the web or in hard copy. Please select from the options below to indicate your consent to allow photo and video of the registered student(s). *
Additional Consent. Please list other adults who may pick up your child from the facility. *
Your answer
Electronic Signature
By electronically signing my name I agree to having read and understood the description, policies and procedures and requirements of Technocopia included in this form and the accompanying links. I also acknowledge that I have explained all applicable policies and procedures to the student(s) registered on this form. Please click "Submit" below to complete your registration.
Full Name *
Your answer
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