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[*] IS REQURED.

Dates [*]
Course [*]
2nd course
8days Participants only
Payment [*]
PC Rental [*]
Coupon Code
Friend Invitation [*]
Friend's Name #1
Friend's Name #2
Friend's Name #3
Parent’s Name [*]
Family Name [*]
First Name [*]
Parent’s Email Address (PC mail) [*]
Confirm
Telephone Number [*]
Address [*]
Participant’s (Child) Name [*]
Family Name [*]
First Name [*]
School Name [*]
Participant’s Date of Birth [*]
year month day
Gender [*]
Participants’ Cell (mobile) Phone’s Number
Life is Tech! Courses s/he has participated before
Experience in PC [*]
Where did you hear about Life is Tech? [*]
Information
Information regarding Allergy or Drugs being taken by your child
In case of medical emergency [*]
I confirm that the all the information entered above is up-to-date and correct.  In case of emergency, if I couldn’t be reached, I understand that the operating company will take my child to the hospital where s/he would receive proper medical treatments.
(incl. injection and surgery with anesthesia) If this can’t be covered by insurance, I agree to pay the necessary fees.
Opinions/Questions
Opinions, Feedbacks, Your Child’s Enthusiasm for the participation!!

 



 Programming IT Camp for Junior High/High School Students
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