FALL 2018 Program Enrollment

Fill out the registration form below, including signing online waiver forms.
Click submit, which will take you to the payment page.
Enter your billing information and submit your payment to complete your registration.

Registration Questions

Student’s Full Name *

Student's Preferred Classroom Name (e.g. Nick versus Nicholas)

First Parent/Guardian’s Full Name *

Second Parent/Guardian's Full Name

First Parent/Guardian’s Phone Number *

First Parent/Guardian’s Phone Number

(###)

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Second Parent/Guardian’s Phone Number

(###)

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First Parent/Guardian’s E-mail Address *

Second Parent/Guardian’s E-mail Address

Student's Email Address

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Hello World Fall 2018 Course Selection *

Check all that apply

St. Stephens Episcopal School - $500 tuition

Gorzycki Middle School - $530 tuition

Casis Elementary School - $500 tuition

Clayton Elementary School - $500 tuition

Kiker Elementary School - $500 tuition

OHenry Middle School - $500 tuition

Mills Elementary School - $500 tuition

Hill Elementary School - $500 tuition

Baranoff Elementary School - $500 tuition

Student's Current School *

Student's 2018-2019 Grade Level *

Student's Date of Birth *

Student's Date of Birth

YYYY

Student's Gender *

Student T-Shirt Size *

Has your student participated in a Hello World program before? *

If yes, please specify when and where:

If no, how did you hear about Hello World?

(Optional) Please specify any programming language experience/exposure your student has gained outside of Hello World:

This will help us ensure our curriculum meets every student where he/she is at!

Student Waiver Forms

Complete student waiver forms on this link.
Please confirm that you completed these below. *

Student Medical Questions

Does your child have any food allergies? *

Does your child have any other allergies? *

Does your child currently take any medications? *

Is there any relevant medical information we should be aware of? *

Is there anything else about your student you would like our team to know?

Parent/Guardian Acknowledgements

In order to complete this application, you must acknowledge "yes" to all statements.

I am the parent/guardian of the student named above. *

I give permission for my child to attend Hello World’s Fall 2018 Program. *

I understand that I am responsible for my child’s transportation arrangements and pick-up each week. *

I understand it is critical for my child to attend all sessions (unless pre-approved by instructor) to ensure he/she does not fall behind. *

I understand Hello World’s cancellation policy. Given the high costs of hardware, software, facilities, and staff resources, cancellations made within 7 days of the first day of the sessions of the selected course will lead to a full refund minus a $50 cancellation fee per course, per student. Cancellations before the 7 day mark will be refunded in full. *

I understand that Hello World has high expectations for all student’s behavior and participation. In the event of a rule/policy violation, the site director may dismiss my child from the program. *

Upon clicking the "Submit" button below you will be directed to initiate payment

St. Stephens Episcopal School

500.00

Quantity:

Add To Cart

Gorzycki Middle School

530.00

Quantity:

Add To Cart

Casis Elementary School

500.00

Quantity:

Add To Cart

Clayton Elementary School

500.00

Quantity:

Add To Cart

Kiker Elementary School

500.00

Quantity:

Add To Cart

OHenry Middle School

500.00

Quantity:

Add To Cart

Mills Elementary School

500.00

Quantity:

Add To Cart

Hill Elementary School

500.00

Quantity:

Add To Cart

Baranoff Elementary School

500.00

Quantity:

Add To Cart