Registration for Mind, Body, & Coding Summer Camp is now open!

Please note that each session below is limited to 30 girls. Each session will be divided into two groups (15 girls each). If students want to be grouped together, please indicate that in the comment section. The middle school session is limited to 15 girls only.

Please note that each girl is limited to registering for 1 week this summer. 

Please download, print, and carefully read the HowGirlsCode Waiver and Hold Harmless Agreement prior to registering your child.

HowGirlsCode Waiver and Hold Harmless Agreement (pdf)

Select Week and Session *
Curriculum repeats each week; please register for one week only.
About Your Child
Address *
Address
Grade *
Please select the grade they will be entering in the Fall of 2016.
About Primary Parent/Guardian
Primary Parent Name *
Primary Parent Name
Primary Home Phone *
Primary Home Phone
Primary Cell Phone *
Primary Cell Phone
About Secondary Parent/Guardian
Secondary Parent Name
Secondary Parent Name
Secondary Parent Cell Phone
Secondary Parent Cell Phone
Individual(s) Authorized for Pick-Up
PLEASE PROVIDE THE NAME, E-MAIL ADDRESS, AND TELEPHONE NUMBER FOR ALL INDIVIDUAL(S) AUTHORIZED TO PICK UP YOUR STUDENT. DO NOT INCLUDE PRIMARY OR SECONDARY PARENTS.
About Emergency Pick-Up
Please provide the name and contact information for someone we may call in the event of an emergency if the primary or secondary parent/guardian cannot be reached.
Emergency Pick-Up Name
Emergency Pick-Up Name
Please describe the relationship between the child and the emergency pick-up.
Emergency Pick-Up Cell Phone
Emergency Pick-Up Cell Phone
About Medical Concerns
Medical Information *
Does your child have any limitations or medical conditions that could affect their participation in this class?
Please explain if you answered yes above. Be sure to include asthma and allergy information.
Parental Consent Forms/Waivers
Photography/Media Release Form *
I grant to HowGirlsCode the right to take photographs of my child during their after-school programming. I authorize HowGirlsCode to copyright, use and publish the same in print and/or electronically. I agree that HowGirlsCode may use such photographs of my child with or without their name and for any lawful purpose, including for example such purposes as news articles, publicity, illustration, advertising, and Web content. Examples of how we use photography online and via twitter can be seen here: http://www.howgirlscode.com/news-and-updates/ .
Acceptance of Waiver and Hold Harmless Agreement *
I accept the Waiver and Hold Harmless Agreement.
Late Pick Up Policy *
Please read and accept our Late Pick Up Policy: Thank you in advance for ensuring that your child is picked up on time. In the event of excessive wait time for pick up, the following policies will apply: After one late pick up of 15 minutes or more, there is a $5.00 fee for the first 15 minutes, and $10 fee for the second 15 minutes and each succeeding 15 minute time segments. After 45 minutes, we will reach out to the emergency contacts to request pickup. After two late pick ups of 15 minutes, we will contact you to discuss terminating your child's participation in the course.
Demographics
Ethnicity *
One of our goals is to ensure we are providing programming to a diverse group of girls. Please indicate your ethnicity.
Please use this space if you have any requests for your child to be in the same group as a friend. Also, please let us know if they have any experience with coding or robotics (Please note - no experience is needed!).

Click "Submit" to complete the registration process and then follow the payment instructions.