Codeie

Coding fair Registration (This is a free event)

Student First Name

Last Name

Age

Grade

School Name

School District

Parent First Name

Last Name

Email ID

Home Number

Cell Number

Address 1

Address 2

City

State

Zip Code

Please specify if your child has any food allergies as we will provide them with breakfast and lunch

Medications

Will they be carrying there medication with them

Yes

Emergency Contact number

Relationship

I give my consent to Codeie LLC. To take pictures of my child in the event. These pictures will be used on website. I agree

Yes