Registration - Hope Road Children

Select your Program(s):

CodyNick Beginner : DISCOVER
(Problem Solving with Coding) - $399.99
Spring Camp
(17~28 MAR) - $449.99

Parent or Guardian's name *

First

Last

or name Select

Participant's Name *

First

Last

Email *

The payment E-transfer needs to be sent from the same email.

Phone Number *

Parent or Guardian's Phone Number.

Participant's Phone Number (optional)

Media Release (Optional)

I acknowledge that photos and videos will be taken during this event, and consent to my child's photos and videos being used for Hope Road Center's video clips.

Total

$0.00

Please E-transfer the registration amount to the following contact:

Mehrnoosh Sartipi
mehrnooshsartipi@yahoo.com

Please set "HopeRoad" as the security answer to your E-transfer, or enter your custom answer below.

Thank you, and hope to see you there!

Security Answer *

Recipt (optional)

I would like to receive an official receipt of this transaction.

Insurance (optional)

I would like to use my insurance for the costs.