Boswin Winter Program Registration
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Program
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Primary Robotics II
Primary Robotics IV
Junior Robotics II
Junior Robotics IV
Zone 01
Student Information
Name
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First Name
Middle Name
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Date of Birth
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Month
-
Day
Year
Date
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M
F
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Street Address Line 2
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Guardian 1 Information
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*
Home Phone
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Cell Phone
*
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Email
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example@example.com
Guardian 2 Information
Name
First Name
Last Name
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Cell Phone
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Email
example@example.com
Primary Emergency Contact
Name
*
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Cell Phone
*
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Email
*
example@example.com
Secondary Emergency Contact
Name
*
First Name
Last Name
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Cell Phone
*
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Email
example@example.com
Does the student have any allergies that we need to be aware of? If yes, please specify.
Does the student have any other medical conditions that we need to be aware of? If yes, please specify.
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My Products
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( X )
Primary Robotics II (Wednesday)
Total program cost is $404
$
113.02
CAD
for the
first month
then,
$
72.75
CAD
for each
month
Primary Robotics II (Saturday)
Total program cost is $336
$
94.18
CAD
for the
first month
then,
$
60.46
CAD
for each
month
Primary Robotics IV (Thursday)
Total program cost is $404
$
113.02
CAD
for the
first month
then,
$
72.75
CAD
for each
month
Primary Robotics IV (Saturday)
Total program cost is $336
$
94.18
CAD
for the
first month
then,
$
60.46
CAD
for each
month
Junior Robotics II (Thursday)
Total program cost is $461
$
129.17
CAD
for the
first month
then,
$
82.96
CAD
for each
month
Junior Robotics II (Saturday)
Total program cost is $384
$
107.64
CAD
for the
first month
then,
$
69.09
CAD
for each
month
Junior Robotics IV (Tuesday)
Total Program cost is $500
$
139.93
CAD
for the
first month
then,
$
90.02
CAD
for each
month
Zone 01
Total program cost is $1128.75
$
451.50
CAD
for the
first month
then,
$
225.75
CAD
for each
month
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