Name *

First Name

Last Name

I would like to participate in: *

Motherboard (June 21, 22, 24, 26)

Student Phone *

(###)

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Contact Parent *

First Name

Last Name

Contact Parent Phone *

(###)

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Terms of Agreement *

By checking the box below, you and your parent/guardian agree to the following terms: 1) I have received permission from a parent/guardian to participate in this program. 2) My parent/guardian will sign & submit the Firebird photo/recording policy (downloaded below). 3) After submitting this form I will contribute in full the workshop fee as listed in the email I have received. 4) I am available and will be present for all four sessions of the workshop, and will follow social conduct rules as given by workshop instructor. 5) I have/will acquire the necessary equipment to fully participate in the workshop, as detailed in the workshop description.

I have read and agree to these terms.