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2067 Broadway Avenue,
Bristol, NY

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432-845-6570

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Childs Information

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Ages of Child(ren)

Child's Full Name

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Any medical conditions we should be aware of?

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If YES, explain briefly the medical or special needs

Preferred class for you child

Pathfinder (5—8) Curiosity ( 9—11) Explorer ( 12—20)

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Please indicate the preferred time slot for the tech class: (I don't know how the timing of the class works, so you can edit it )

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I give consent for my child to participate in the Bootcamp and understand that appropriate safety measures will be taken

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If YES, explain briefly the medical or special needs

Any medical condition or special needs of the child *

Yes No

How did you hear about our programs? *

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Preferred class for you child *

Pathfinder (5—8) Curiosity ( 9—11) Explorer ( 12—20)

Do you have good working laptop and strong internet access *

Yes No Will buy one

I give consent for my child to participate in the Bootcamp and understand that appropriate safety measures will be taken *

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Registration Fee: A registration fee of $199 is required to secure your child's spot. Payment instructions will be provided upon form submission. Please review your information before submitting. Upon submission, you will receive a confirmation email with further details. *

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KM 25, Lekki-Epe Expressway, Lagos .

+234 91 565 85349
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+234 91 565 85349
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