Young Geniuses Code Lab Registration
In the Young Geniuses Code Lab, youth and young adults are introduced to computer software development by working on fun projects including video games, websites, mobile apps and devices. Programming languages including Ruby on Rails, JavaScript, HTML5/CSS, Python and other tools.

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PARTICIPANT FIRST NAME *
PARTICIPANT LAST NAME *
Gender
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AGE
GRADE
SCHOOL
INTERESTS/TALENTS
PREVIOUS COMPUTER PROGRAMMING/EXPERIENCE (PLEASE DESCRIBE)
DOES YOUR CHILD HAVE ACCESS TO COMPUTER AND INTERNET AT HOME?
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DOES YOUR CHILD HAVE A LAPTOP COMPUTER THAT THEY CAN USE IN CLASS?
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PARENT/GUARDIAN FIRST NAME *
PARENT/GUARDIAN LAST NAME *
ADDRESS *
CITY *
ZIP *
PHONE 1 *
PHONE 2
Email *
FACEBOOK
TWITTER
How did you hear about the program?
Are you able to commit to your child's attendance and punctuality for each session? *
Consistent attendance is very important so that participants can keep up with the course work and maximize their learning and retention.
Consent Form *
By checking this box I consent that I am the parent/guardian of the child listed above and I give permission for my child to fully participate in the Young Geniuses Program and the Umoja P.E.A.C.E. Center & Africatown Center for Education & Innovation activities including but not limited to transporting my child, photograph, filming and/or recordings of my child for promotional purposes.  
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