Program Registration

Parent Full Name *
TelePhone *
Mobile Phone
Address *
Email Address *
No of Participants *
Preferred Program *
Robotics (8-13 years)All about bridges ( 5-13 years)Power your city ( 8-13 years)Light up your world (5-7 years)
Preferred Schedule *
FridaysSaturdaysCamp (Sun-Mon- Tues - Wed -Thr).After School
Preferred Timings *
How did you hear about Engineeius *
Name of Second Child *
Birthdate of Second Child *
School Name *
School Type *
Grade of Second Child *
Name of Third Child *
Birthdate of Third Child *
School Name *
School Type *
Grade of Third Child *
By filling out this application, I agree to Engineeius rules and regulations as well as using my kids' pictures through Engineeius' social networks.

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