School Name

Child's First Name

Child's Last Name

Child's Gender Child's GenderGirlBoy

Child's Date of Birth

Child's Age

Allergies

T-Shirt Size T-Shirt Size2-34-55-67-89-10

Payment Options Payment Options10 monthly payments4 termly payments

Mother's First Name

Mother's Last Name

Mother's Number

Mother's Email

Father's First Name

Father's Last Name

Father's Number

Father's Email

Liability Waiver Liability Waiver I hereby acknowledge that I shall have no claims whatsoever against Robotix by Build em Brix staff, Managers, or any other staff member associated with the company, which may arise in the result of injuries, damage, or any loss of personal items whilst participating in the sessions held at the above school or any organised event.