Summer Robotics Workshop/ RoboCamp Enrollment Page

2009 Summer Robotics Workshops Enrollment Form

Prefer sending in the physical forms

Prefer Online Registration

Personal Contact Section

Date:
Participant's Name:			M F
	D.O.B.:	Grade Level:	(by the Fall of 2009)
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:	You will have the flexibility to change the pick up time. Therefore, extended care fee is not due until the last day of the camp. Please note that pickup time 15 minutes into an hour will be subject a full $10/hour rate. 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	I am not I am interested. (You only pay if you choose to order. Selection and payment must be made at the drop-off time) ***Friday: FREE Pizza Day!

Workshops Selection Section
-- View Courses Description --	%Available % Filled
-- Click on the tab to view the courses selection -- -- Advanced Challenge Track is noted with [ACT] --

Tuition adjustment Section

Subtotal
Additional module x $20 (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 (-$30 by 3/6, -$20 by 4/15, -$10 by 5/15	- $
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:	$
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

(span style="font-size: 80%">maximum 2000 characters)

payment Section

	Select Payment Option: Full payment $200 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, 2009. (Must provide CC authorization below.) Pay balance with check by June 1st, 2009. (Please submit on time in order to avoid $10 Late Charge which will incur after June 1st, 09).
	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, 2009. 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

All classes are taught by highly qualified staff with post graduate degrees in science/education discipline.
Select	Modules	Cost	Status

Jul 20-24	Robotics Fun with Mathematics [ACT] (Up to Gr. 7)	$435	FULL

Jul 27-31	A.I. for Logic Game: Program to play against Human	$495
	[ACT] (Gr. 7+)

Aug 03-07	Advanced - Create Your Own Video Game	$435

Aug 03-07	Motion Sensing Control [ACT] (Gr. 7+)	$495	FULL
	(Simulating Wii controller)

Aug 10-14	Learning Java with Mindstorms Robots [ACT] (Gr. 7+)	$495

Aug 17-21	Tomb Expedition [ACT] (Up to Gr. 8)	$435
	(a.k.a.) Distributive Intelligence

All ACT students will take home: - a practical souvenir - a book about pursuing Engineering & Technology in college.

Select	Modules	Cost	Status
Jul 06 - 10	P.R.O.B.E. Planetary Space Mission	$415

Jul 13 - 17	RoboDog vs. RoboMailman	$415

Jul 20 - 24	Robotics Fun with Mathematic (Gr. 5+) [ACT]	$435	FULL

Jul 20 - 24	Robo500 Grand Challenge & Drag Racing	$415

Jul 27 - 31	Create Your Own PC Game	$425	FULL

Aug 17-21	RoboRescue Mission (New!)	$415

Aug 24-28	Mindstorms Robotics Zoo (New!)	$415

All students will take home a practical souvenir.

Most of our Gr2-3 programs are filled by April. Enroll early to reserve a seat!
Select	modules	Cost	Status

Jul 06 - 10	Amusement Park I \| 9-11:45A	$220

Jul 06 - 10	Ferris Wheel \| 12:15-3:15P (New!)	$270
	*** Bring home the Ferry's Wheel
Jul13 - 17	Thematic Music Box \| 9-11:45A (New!)	$220

Jul13 - 17	Mindstorms RoboDog \| 12:15-3:15P	$270
	*** Bring home the Mechanical RoboDog
Aug 10 - 14	Amusement Park II \| 9-11:45A	$220

Aug 10 - 14	Pneumatic Robohand \| 12:15-3:15P (New!)	$270
	*** Bring home the Your Robohand
All students will take home a practical souvenir.