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.
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Travilah K-3 March-May
Travilah Grades 4-5 Intro R/C March-May
Travilah Grades 4-5 Intermediate R/C March-May
Rock Creek Valley Grades 4-5 Intro R/C April-June
Rock Creek Valley Grades 4-5 Intermediate R/C April-June
Rock Creek Valley Grades K-3 Lego April-June
Flower Valley K-3
Flower Valley Grades 4-5
007 School of Genius
Warren-Prescott School Grades K1ED & KED April-June
Warren-Prescott School Grades FED & SED April-June
St. Bartholomew Grades 4-6 Intro R/C March-May
St. Bartholomew Grades 4-6 Intermediate R/C March-May
South End Tech Center STEAM
Travilah K-3 LEGO Engineering March-May
This program will run from March 23rd through May 18th on Thursdays from 3:50pm to 5:50pm. There will be no class on April 13th.
Travilah 4-5 Intro to R/C Racing Stem Academy March- May
This program will run from March 23rd through May 18th on Thursdays from 3:50pm to 5:50pm. There will be no class on April 13th.
Travilah 4-5 Intermediate R/C Racing Stem Academy (Intro course required) March- May
This program will run from March 23rd through May 18th on Thursdays from 3:50pm to 5:50pm. There will be no class on April 13th.
Rock Creek Valley K-3 Lego Engineering May-June
This program will run from May 2nd through June 20th on Tuesdays from 4:00 - 6:00pm.
Rock Creek Valley Grades 4-5 Intro R/C May-June
This program will run from May 2nd through June 20th on Tuesdays from 4:00 - 6:00pm.
Rock Creek Valley Grades 4-5 Intermediate R/C May-June
This program will run from May 2nd through June 20th on Tuesdays from 4:00 - 6:00pm.
Flower Valley K-3 Lego Engineering
This program will run from January 25th through March 15th on Wednesdays after school from 3:30 to 5:30.
Flower Valley Grades 4-5 Robotics
This program will run from January 25th through March 15th on Wednesdays after school from 3:30 to 5:30.
Warren-Prescott School Grades K1ED & KED April-June
This program will run from April 13th through June 22nd on Thursdays after school from 4:00 to 4:50 PM. There will be no class on April 20, 2017.
Warren-Prescott School Grades FED & SED
April-June
This program will run from April 13th through June 22nd on Thursdays after school from 4:00 to 4:50 PM. There will be no class on April 20, 2017.
007 School of Genius
This is a demo for Deilab staff. For users, this will display:
This program will run from (date) through (date) on (day of week) from (time) to (time) in (place).
St. Bartholomew School Grades 4-6 DEILAB Intro R/C Racing Academy (DRCA) March-May
This program will run from March 8th through May 3rd on Wednesdays from 3:15 to 5:15. There will be no class April 19th.
St. Bartholomew School Grades 4-6 DEILAB Intermediate R/C Racing Academy (DRCA)
This program will run from March 8th through May 3rd on Wednesdays from 3:15 to 5:15. There will be no class April 19th.
South End Tech Center Grades 2-5
This program will run from January 11th through March 22nd on Wednesdays from 4:00 to 6:00. There will be no class February 22nd.
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Date of Birth
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Pre-Kindergarten
Kindergarten
First Grade
Second Grade
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Fourth Grade
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Teacher's Name
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Emergency Contact Information
Parent 1 Name
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Best Phone Number
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Alternate Phone Number
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Email
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Parent 2 Name
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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.)
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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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