Silverstone - STEM Summer Course Booking Form 2024

Silverstone - STEM Summer Course Booking Form 2024

Booking Form - Silverstone UTC
Your Details
First Name*
Last Name*
Email*
example@example.com
Phone Number*
Address*

Address

Address Line 2

CityCounty

Postcode
Relationship to child?
Emergency Contact

Please give us a different contact than the person named above. This contact will be used if we are unable to contact the person named above.
Name*

First NameLast Name
Phone Number*
Relationship to child?*
Child Details
First Name*
Last Name*
Date of Birth*

DayMonthYear
Date
Address*

Address

Address Line 2

CityCounty

Postcode
YesNo
If you have answered 'yes', please give more details including symptoms, triggers, signs, treatment etc.
YesNo
If you have answered 'yes', please give more details e.g. name of medication, when and how it will need to be administered.
YesNo
If you have answered 'yes', please give us more details and indicate what adjustments we can make to ensure they are able to access the course.
YesNo
Week selection & payment

T&Cs apply.

Please select the week and course for this child. Children must be 8 years or older and under 14 years of age. We base our groupings on the school year the child will begin in Sept 2024. Junior: Going into year 4, year 5 and year 6. Senior: Going into year 7, year 8 or year 9.*

WEEK 1 - JUNIOR - Robotics & Racing - Deposit Payment Product Image

WEEK 1 - JUNIOR - Robotics & Racing - Deposit Payment

Monday 19th Aug to Friday 23rd Aug 2024

£258.00

WEEK 1 - SENIOR - Robotics & Racing - Deposit Payment Product Image

WEEK 1 - SENIOR - Robotics & Racing - Deposit Payment

Monday 19th Aug to Friday 23rd Aug 2023

£258.00

WEEK 1 - JUNIOR - Flight & Space - Deposit Payment Product Image

WEEK 1 - JUNIOR - Flight & Space - Deposit Payment

Monday 19th Aug to Friday 23rd Aug 2024

£258.00

WEEK 1 - SENIOR - Flight & Space - Deposit Payment Product Image

WEEK 1 - SENIOR - Flight & Space - Deposit Payment

Monday 19th Aug to Friday 23rd Aug 2024

£258.00

WEEK 2 - JUNIOR - Robotics & Racing - Deposit Payment Product Image

WEEK 2 - JUNIOR - Robotics & Racing - Deposit Payment

Monday 26th Aug to Friday 30th Aug 2024

£258.00

WEEK 2 - JUNIOR - Flight & Space - Deposit Payment Product Image

WEEK 2 - JUNIOR - Flight & Space - Deposit Payment

Monday 26th Aug to Friday 30th Aug 2024

£258.00

WEEK 2 - SENIOR - Robotics & Racing - Deposit Payment Product Image

WEEK 2 - SENIOR - Robotics & Racing - Deposit Payment

Monday 26th Aug to Friday 30th Aug 2024

£258.00

WEEK 2 - SENIOR - Flight & Space - Deposit Payment Product Image

WEEK 2 - SENIOR - Flight & Space - Deposit Payment

Monday 26th Aug to Friday 30th Aug 2024

£258.00

Enter coupon

Total

£0.00

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

YesNo
Should be Empty: