Shiva Robotics Academy - Summer Camp Registration Form

LEGO ROBOTICS CLASS REGISTRATION FORM

If you are a new student, please ensure to fill in all fields.
If you are a returning student then just fill in the Kid's Name, Email and Phone number fields and then you can proceed to Camp Option selection.

* Indicates required field

Kid's Name *

First

Last

Kid's Current School Name *

Kid's DOB in MM/DD/YYYY format *

Kid's Gender *

Male Female

Parent's Name *

First

Last

Email *

Phone Number *

How did you get to know about our Summer Camp ? *

Internet Search Advertisment Friend Other

7044 Beach Blvd
Jacksonville
FL 32216.

Wednesday: 4 - 7 pm
Saturday: 10 am to noon

904-704-7046

build@ShivaRobotics.com

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