Programs Registration
Are you registering more than one child?
no
yes
Child Name
*
First Name
Last Name
Child 2 Name
First Name
Last Name
Child 3 Name
First Name
Last Name
Grade
*
Child 2 Grade
Child 3 Grade
Parent Name
*
First Name
Last Name
Parent Cell Phone
*
-
Area Code
Phone Number
If registering for Chess, does your child know how the pieces move?:
Yes
No
If registering for Chess, does your child 2 know how the pieces move?:
Yes
No
If registering for Chess, does your child 3 know how the pieces move?:
Yes
No
If registering for Minecraft, your child's Minecraft name:
Required to whitelist your child into our server.
If registering for Minecraft, your child 2 Minecraft name:
Required to whitelist your child into our server.
If registering for Minecraft, your child 3 Minecraft name:
Required to whitelist your child into our server.
Email (this email will be used to notify you re connecting via Zoom)
*
example@example.com
Special Note
Payment Information
*
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December Mini Camp
December Mini Camps
Quantity
Price
Chess Mini Camp
1
2
3
4
5
$
50.00
Minecraft Mini Camp
1
2
3
4
5
$
50.00
Item subtotal:
$
0.00
Chess Team
Winter Chess Team
Quantity
Price
Chess Team
1
2
3
4
5
$
175.00
Item subtotal:
$
0.00
January Courses
$
65.00
January
Quantity
January Chess
1
2
3
4
5
January Minecraft SECTION 1 (Java only)
1
2
3
4
5
January Minecraft SECTION 2 (Devices and Windows 10)
1
2
3
4
5
February Courses
$
65.00
February
Quantity
February Chess
1
2
3
4
5
February Minecraft SECTION 1 (Java only)
1
2
3
4
5
January Minecraft SECTION 2 (Devices and Windows 10)
1
2
3
4
5
March Courses
$
65.00
March
Quantity
March Chess
1
2
3
4
5
March Minecraft SECTION 1 (Java only)
1
2
3
4
5
March Minecraft SECTION 2 (Devices and Windows 10)
1
2
3
4
5
Enter coupon
Apply
Total
$
0.00
Credit Card Information (we accept Visa, MasterCard, Discover, and Amex)
First Name
Credit Card Number
Security Code
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
Expiration Year
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