ITWomen Camp Registration

Parent/Guardian First Name: Parent/Guardian Last Name: Parent/Guardian Email: Day Phone: Address Line 1 Number of Girls You Are Registering With This Form Media Release I hereby grant permission for ITWomen to utilize photographs of student in promotional materials, pertaining to the Summer Robotics Camps on its website, social media accounts, and press efforts that acknowledge generosity of the camp Sponsors. I certify I am the parent/guardian authorized to provide this information on behalf of the girls being registered. Emergency Contact Name Emergency Contact Phone I am not a robot