Engineering in the Wizarding World - Saratoga, December 2nd Registration

Date of Birth *
Date of Birth
Parent Name *
Parent Name
Address *
Address
Parent Cell Phone Number *
Parent Cell Phone Number
Parent Home Phone Number *
Parent Home Phone Number
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
The EYE Staff is American Red Cross CPR/AED/First Aide Certified
The EYE Saturday Program provides a free pizza lunch for all participants! To avoid wasting food, please check the appropriate box below. *
Photo Release Consent *
I give consent for photos of my child taken at the EYE Saturday Program to be used in the promotion of further elementary engineering programs in Saratoga Springs.