Everyone Can Code Waitlist (Virtual Training)
8 Week Course on Tuesdays and Thursdays Date (TBD)
Student's Full Name
*
First Name
Last Name
Student's Email Address
*
example@example.com
Parent's Full Name
First Name
Last Name
Parent's Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Demographics
What school do you attend?
How did you hear about the event?
What is your zip code?
Gender
Male
Female
Gender Fluid
N/A
Age Range
Please Select
10
11
12
13
14
15
16
17
18
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Student's Signature
Parent's Signature
Media Release Agreement
Please review and agree before submitting.
Photo and Media Release Consent
*
I agree to the NCBW
Photo & Media Release Policy
.
Register
Register
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