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Random Math Summer Camp - 2020
Registration Form
Contact us at
learning@randommath.com
for any questions.
1. Student Information
Student Full Name
School
Birthday
Grade
Does the student require any special accommodations to participate in the program?
Select one...
Yes
No
Does your child have any allergies/intolerance to food, medication, or any other substances?
Select one...
Yes
No
2. Parent Information
Mother's Full Name
Mother's Email
Mother's Phone Number
Father's Full Name
Father's Email
Father's Phone Number
Address
City
State
Zip Code
3. Camp Selection
Camp Epsilon - Counting & Probability-July 27 to August 07
Camp Epsilon - Full Day (9:00am-4:30pm) - $1200
Camp Epsilon - Morning Session (9:00am-12:15pm) - $800
Camp Epsilon - Afternoon Session (1:30pm-4:30pm) - $800
4. Additional Information
How did you hear of us?
Select one...
Web Search
Friends and Family
Other
5. Acknowledgement of Terms
Random Math Camp is a fee-for-service program based on confirmed enrollments and secured deposits. In order to reserve your child(ren)’s spot, full payment must be received for each child and session you are registering for.
Student(s) would need to take an assessment before placement can be confirmed.
I HAVE CAREFULLY READ THE RANDOM MATH CLASS POLICIES. MY SIGNATURE BELOW INDICATES COMPLIANCE WITH RANDOM MATH POLICIES. I SIGN IT FREELY AND VOLUNTARILY.
Parent or Guardian - Your signature below indicates compliance with Random Math summer camp regulations.
Parent or Guardian Signature
Date
I agree to receiving marketing and promotional materials.
Thank you! Your submission has been received!
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