brickLAB's Young Engineers Program Trial Class Registration Form
Please fill out this form to register for a trial class in our after school or homeschool program.
Child's Full Name
*
First Name
Last Name
Child's Age
*
Ages 7+
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Which program are you interested in?
*
Homeschool Program (1:00pm-3:00pm)
After School Program (4:30pm-6:30pm)
Trial Options (Select one)
prev
next
( X )
Single Day Trial
$39.95
$
39.95
3 - Day Trial
$89.95
$
89.95
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Date
*
-
Month
-
Day
Year
If booking 3-day trial, please select the tuesday of the week you would like to participate.
Tuesdays - Robotics
Wednesdays- Stop Motion Film
Thursdays - Simple Machines
Register
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