Select a Week(s)
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Choose which week(s) you want to volunteer.
Select an Age Group
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Choose with age group you would prefer to work with.
Select a Course
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Choose which course you want to volunteer with.
General Comments
Please use this space if you have any other special requests. Also, please let us know what your experience is with coding, robotics, and/or yoga.
First Name
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Last Name
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Volunteer's Phone Number
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Please provide the best phone number to contact the volunteer regarding volunteer status, volunteer training information and other camp information.
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T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
School
*
Grade
*
Please select the grade you are entering in the Fall of 2019.
Ethnicity
*
One of our goals is to ensure we are providing programming to a diverse group of girls and providing diversity with our instructors and volunteers. Please indicate your ethnicity.
Primary Parent Name
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If you are 18 years or older - enter your own information in this section and skip the Secondary Parent section.
First Name
Last Name
Primary Home Phone
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Primary Cell Phone
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Primary Email Address
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Secondary Parent Name
First Name
Last Name
Secondary Parent Cell Phone
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Secondary Parent Email
Pick-Up Exemption
*
This section does not apply to me because I am 18 years old or will be driving myself to and from camp.
Name, E-mail Address, & Telephone Number
Please provide the Name, E-Mail Address, and Telephone Number for all Individual(s) authorized to pick up your child. Do not include primary, secondary, or emergency pick-ups. For example, another parent with a child in the same camp, a babysitter, etc.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Cell Phone
*
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Medical Concerns
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Do you have any limitations or medical conditions that could affect your participation in this camp?
Medical Comments
Please explain if you answered yes above. Be sure to include asthma and allergy information.
Photography/Media Release Form
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I grant to HowGirlsCode the right to take photographs of my child during their after-school programming. I authorize HowGirlsCode to copyright, use and publish the same in print and/or electronically.
I agree that HowGirlsCode may use such photographs of my child with or without their name and for any lawful purpose, including for example such purposes as news articles, publicity, illustration, advertising, and Web content.
Examples of how we use photography online and via twitter can be seen here: http://www.howgirlscode.com/news-and-updates/ .
Acceptance of Waiver and Hold Harmless Agreement
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I accept the Waiver and Hold Harmless Agreement.
Late Pick Up Policy
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Please read and accept our Late Pick Up Policy: Thank you in advance for ensuring that your child is picked up on time. In the event of excessive wait time for pick up, the following policies will apply: After one late pick up of 15 minutes or more, there is a $5.00 fee for the first 15 minutes, and $10 fee for the second 15 minutes and each succeeding 15 minute time segments. After 45 minutes, we will reach out to the emergency contacts to request pickup. After two late pick ups of 15 minutes, we will contact you to discuss terminating your child's participation in the course.
Reference 1 Name
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First Name
Last Name
Reference 1 Email
*
Reference 1 Phone Number
*
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