Summer Robotics Workshop/ RoboCamp Enrollment Page

2010 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 2010)
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 the first day of your workshop(s). Must submit credit card authorization for this charge. No charge is made until the end of workshops. $12/hr with 10 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	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
-- Get Direction--	%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 3/1, -$20 by 3/15, -$10 by 4/15	- $
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

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, 2010. (Must provide CC authorization below.) Pay balance with check by June 1st, 2010. (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, 2010. 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 12-16	Robotics Fun with Mathematics [ACT] (Rising Gr. 6-8)	$455

Jul 19-23	Physics with Robotics [ACT] (Rising Gr. 7+)	$495

Jul 26-30	Motion Sensing Control [ACT] (Rising Gr. 7+)	$495
	Simulating Wii Controller
Aug 2-6	Robotics Rescue [ACT] (Rising Gr. 7+)	$455
	(just added on July 6th)
Aug 9-13	Robotics Treasure Hunting [ACT] (Rising Gr. 7+)	$495
	Working with GPS Receiver
Aug 16-20	Robotics Treasure Hunting [ACT] (Rising Gr. 7+)	$495
	Working with GPS Receiver


Select	Modules	Cost	Status
Jul 05 - 09	Robo500 Grand Challenge & Drag Racing	$425

Jul 26 - 30	Robo Seek And Destroy	$425

Aug 2 - 6	Robotic Whack-A-Mole Contest	$425

Aug 2 - 6	Remote Control Racing Bot	$425

Aug 9 - 13	RoboRescue Mission	$425

Aug 16 - 20	Robo Secret Agent Mission	$425

Aug 23 - 27	Mindstorms Robotics Zoo	$425

Aug 23 - 27	Remote Control Racing Bot	$425

Register early to reserve a seat!
Select	modules	Cost	Status

Jul 05 - 09	Mechanical RoboDog \| 9-11:45A	$270
	*** Bring home the Mechanical RoboDo
Jul 05 - 09	Amusement Park I \| 12:15-3:00P	$220

Jul 12 - 16	Ferris Wheel \| 9-11:45A	$270
	*** Bring home the Ferris Wheel
Jul 12 - 16	Amusement Park II \| 12:15-3:00P	$220

Jul 19 - 23	Mechanical RoboDog \| 9-11:45A	$270
	*** Bring home the Mechanical RoboDog
Jul 19 - 23	Missions Mars \| 12:15-3:15P	$220