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2012 Summer Robotics Workshops Registration Form

At Storming Robots
Personal Contact Section
Date:
 
Avoid Spam! < Enter the capital city of New Jersey.
 Participant's Name:    D.O.B.:   Gr. Level:  M   F
   

(by the Fall of 2011)
Parent/Guardian:
Home Address:
City:   State    Zip:
       
Home  Phone (xxx-xxx-xxxx)

Work:

Cell:

E-Mail Address:

You will receive registration and payment confirmation thru email.
Extended Care:  
  • Flexible but must be informed no later than two weeks prior to your workshop(s).
  • Credit Card Authorization is required on file. Actual charge does not take place until the last day of your  workshop week.
  • $12/hr with 15 minutes into an hour will be considered to be as full hour.  

do not need  until 4pm    until 5pm    until 6pm
Previous Robotics Experience No LEGO Mindstorms Experience
Some LEGO Mindstorms Experience
FIRST LEGO League Experience
Have other robotics programming: 
Learn about us:             Others:
Emergency and Physician Contacts
Contact Ph:  
Physician Ph:  

Allergies/ medication/ or other conditions that we should know
 
Misc. Information
Carpool List   I am not     I am interested.       Read our Carpool List Policy 
Note: Even you select "Yes", you won't be added in our carpool list until someone from our office has contacted you for verification.
Lunch Purchase *  Selection and payment are made at the drop-off time only.
*  Friday: FREE Pizza Day!

Workshops Selection Section
-- Get Direction--    %Available % Filled
-- Click on the tab to view the courses selection --
-- Advanced Challenge Track is noted with [ACT] --
Rising Grade 7 & Up  <<click here

All classes are taught by highly qualified staff with post graduate degrees in science/education discipline.
Select Modules  [ACT] Location Cost Status
Jul 9-13 Programming in C with Algebra   (9am - 12:00pm) SR $265
  ($30 reduction if registration for both AM & PM) 
Jul 9-13 Programming in C with Robot  (12:30 - 3:30pm) SR $265
        
Jul 16-20 Robotics with Bluetooth / Inter-Robotcs
      Communication(IRC)  (9am - 3pm)		 SR $510
 
Jul 23-27  Robotics Soccer (9am - 3pm) SR $510
 
Jul 30-Aug3 Physics with Robotics I (at RPS)   (9am - 12:00pm) RPS $270
    ($30 reduction if registration for both AM & PM) 
Jul 30-Aug 3 Physics with Robotics II (at RPS)   (12:30 - 3:30pm) RPS $270
  
Aug 6-10 Motion Sensing Control (IRC) SR $510
          (9am - 3pm) 
Aug 13-17 Electronic and Robotics with Arduino SR $510
 
  Rising Grade  6 to 8   <<click here
 
Select Modules Location Cost Status
Jul 30-Aug 3 Robotics Fun with Mathematics [ACT] SR $465
         
   
Rising Grade 4 to 8    <<click here
Register early to reserve a seat!
All of the following sessions are held at the Storming Robots main location.
Select Modules (9am to 3pm) Location Cost Status
 Jun25-29 Robotic Technology Projects SR $435
        
Jun25-29 Engineering For Girls
SR $435
         
Aug 20-24 Robotic  Technology Projects SR $435
   
Rising Grade 4 to 6   <<click here

All of the following sessions are held at the Storming Robots main location.
Select Modules (all 9am to 3pm) Cost Status
Jul 9-13 Robo500  Grand Challenge & Drag Racing $435
       
Jul 16-20 Robotic Safari $435
Jul 23-27 Remote Control Racing Bot $435
Jul 30-Aug 3 Robotics Scavenger Hunt $435
       
Aug 6 - 10 Robot Sabotage $435
  
Aug 13 - 17 Robotics  BioMed Missions $435
 
Aug 20 - 24 Robo500 Grand Challenge & Drag Racing $435
 
Rising Grade 2 to 3    <<click here
Register early to reserve a seat!
The following sessions are held at the Dean of Chess location.
Select Modules Location Cost Status
Jul 16-20   Mechanical RoboDog | 9-11:45A  DOC $280
*** Bring home the Mechanical RoboDog 
Jul 16-20  Amusement Park I  | 12:15-3:00P
(Merry-Go-Round + Ferris Wheel)
 DOC $225
    
Aug 6-10   Pneumatic Robohand | 9-11:45A  DOC $280
*** Bring home the Pneumatic Hand
Aug 6-10   Amusement Park II | 12:15-3:00P
(Ghost Ride + Bumper Car)
DOC $225
       
     
All students will also receive
-- Work Habit and Performance Report --
-- Robotics Pin   --
Tuition adjustment Section

 Subtotal
  Additional module x $30 (ONLY apply to Summer Modules) - $
   SR's alumni - $
Note: ONLY apply to the participants who have attended either Summer
week long workshops or roboclub at Storming Robots' site previously.
  I am the sibling of another student named - $
Note: ONLY apply to the camper with the lower or equal value. Max -$100.
  
   Register Now (-$40 by 2/29, -$30 by 3/31, -$20 by 4/30 - $
  I have read and agreed to the Refund Policy ***
 My child Has Read  and agreed  to conform with the  code of conduct  at the Center. ***
(Please note that *** Must be checked in order to be accepted into our programs.)

Total Camp Fee Due:

$

Submit Now:
Minimum $250 deposit
required for registration.

$
Dear parents, it is important that your child has read our code of conduct and he/she will have no problem to conform.  The quality of these robotics workshops/robocamp programs relies not only on the high quality of our staff and programs, but also the cooperation and respect from the students.

Note: We shall regret not to accept student who does not agree to our code.

Important Note:

  • Staff is not permitted to dispense medications.  Arrangements MUST be made accordingly before the beginning of your registered session.  
  • Your online submission will reserve a seat.  Please note that a camper is not fully registered until we have received the "Total" camp fee.   An enrollment confirmation will be sent to you as soon as payment is received. 
  • Checks returned for insufficient funds will be charged $50, which includes $15 processing fee and $35 bank fee .
  • The center is not responsible for lost and/or left-behind personal property. You must come in to pick up left-behind items.
Comments or Questions or email us at robocamp @ storminigrobots.com
maximum 2000 characters)
payment Section
Select Payment Option:
Full payment
$250 down payment to reserve a seat
*** must check one of the following if this option is selected:
  New Member Payment Plan. (Must provide CC authorization below.)
  Alumni Payment Plan. (Must provide CC authorization below.)
 Charge remaining balance on June 1st, 2011. (Must provide CC authorization below.)
  Pay balance with check by June 1st, 2011.
      (Please submit on time in order to avoid $10 Late Charge which will incur
       after June 1st,  10).
 
Select Payment Method:
Submit Payment with Check. (Must meet the minimum deposit.)
Submit CC for Recurring Payment. 
** Equal monthly CC payments (from now through July 1st, 2011. A staff will contact you for setting up recurring charge profile.
Submit CC Payment.
    (This selection will bring you to the payment page. Please make sure your browser will allow pop up.) 		 
 

If you choose to pay with check, please make checks or money orders payable to: Storming Robots. Mail it to:
Storming Robots
3322 Rt. 22 West, Suite 402
Branchburg, NJ 08876
  
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