Storming Robots Robotics Club Enrollment Form

Roboclub Renewal Form

Reminder:
View Spring 2010 Meetings Schedule. Makeup and refund policy.

I. main Section

Participant's Name:

E-Mail Address:

Avoid Spam!

< Enter the capital city of New Jersey.

Renew for:

Fall 2010 Term (View the full term calendar)

II. Change of meeting hours Section

Complete this section only if you wish to change sessions.
Please view the available meeting sessions and enter it here:
Our administrator will contact you regarding the availability.

III. Change of Contact Information Section

Complete this section only if your mailing address or phone number has changed or is incorrect on the Student Project Assessment Document.

Date:

Parent/Guardian:

Home Address:

City:

State
Zip:

Home Phone (xxx-xxx-xxxx) Work: Cell:

Comments:

Please state allergies/ medication/ or other conditions that we should know of about this student.
(maximum 2000 characters)

IV. Change of Make-up policy

In order to maximize the quality of our programs, we regret that we must restrict the makeup sessions. Please read the Make-up policy.

IV. Payment Section

$ per term (12 sessions)

Select one of the options below and click on "Submit here" button.

Continue with Three Equal Monthly Recurring Charge using Past CC Reference.
(Allow Storming Robots to charge monthly for the extent of your enrolled period.)

Submit with Check Payment.(Please view the payment policy.)

Submit full payment via past CC Reference.

Submit new CC for three Monthly Recurring Charge.
(This selection will bring you to the payment page.)

Submit new CC for Full payment.
(This selection will bring you to the payment page.)

You will receive a confirmation via email after payment is received
All payments must be submitted no later than 15 days prior to the signed up month.

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

Complete this section only if your mailing address or phone number has changed or is incorrect on the Student Project Assessment Document.
Date:
Parent/Guardian:
Home Address:
City:
	State	Zip:
Home Phone	(xxx-xxx-xxxx)	Work:	Cell:

Reminder: