Parent's First Name*

Parent's Last Name*

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Child's First Name*

Child's Gender*
n/afemalemale

Child's Grade *Must be at least 5th Grade*
n/a1st2nd3rd4th5th6th7th8th

Which Tech are you interested in?*
n/aCodingRoboticsGame DesignDigital Arts

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n/aYesNo