Wufoo
Deilab Enrollment Form
Please select which of our camps or after school programs you would like to enroll in and provide the information requested below.
Select a Program
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Warren-Prescott School Grades K1ED, KED, FED, and SED April-June Lego
Warren-Prescott School Grades SED, 3AS, 4AS, 5AS, 6AS April-June Robotics
RCV K-3 Lego Engineering March-May
RCV 4-5 Intro to R/C Racing March-May
RCV 4-5 Intermediate R/C Racing March-May
Warren-Prescott School Grades K1ED, KED, FED, and SED April-June Lego Engineering
This program will run from April 5th through June 14th on Thursdays after school from 5:00 to 5:50 PM. There will be no class on April 19th, 2018.
Warren-Prescott School Grades SED, 3AS, 4AS, 5AS, and 6AS April-June Robotics
This program will run from April 5th through June 14th on Thursdays after school from 5:00 to 5:50 PM. There will be no class on April 19th, 2018.
RCV K-3 Lego Engineering March-May
This program will run from March 6th through May 1st on Tuesdays after school from 4:00 to 6:00 PM.
RCV 4-5 Intro to R/C Racing March-May
This program will run from March 6th through May 1st on Tuesdays after school from 4:00 to 6:00 PM. This program is for students who have not enrolled in a DEILAB R/C class in the past.
RCV 4-5 Intermediate R/C Racing March-May
This program will run from March 6th through May 1st on Tuesdays after school from 4:00 to 6:00 PM. This program is for students who have enrolled in a DEILAB R/C class in the past.
Participant's Name
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First
Last
Date of Birth
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Grade
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Pre-Kindergarten
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Teacher's Name
Please list any allergies
Please list any other medical conditions we should be aware of
Emergency Contact Information
Parent 1 Name
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First
Last
Best Phone Number
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Alternate Phone Number
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Email
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Parent 2 Name
First
Last
Parent 2 Phone Number
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Please provide names and contact information for any other individuals you authorize to pick up your child in case of emergency (i.e. babysitter, grandparent, older sibling, etc.)
Please check
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I hereby authorize Deilab to contact any and all of the individuals listed above in the event of an emergency concerning my child.
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