Clone of BrainyBuilders Registration Form

BrainyBuilders 2026 Summer Camp Registration

This form is for first time registering only. Returning users, will complete Returning Registration Form. Please complete one form per child. Those registering multiple children will need to fill out multiple forms.
Parent First Name*
Parent Last Name*
Parent Address*
City*
State*
Zip *
Parent (Guardian) Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent (Guardian) Name Email*
example@example.com
Student Name*

First NameLast Name
Student Age*
MaleFemale
Black/African-AmericanHispanicWhite/CaucasianNative AmericanMultiracial/Two or More RacesOther
Student's Grade (as of 2025-2026 School Year)*
What school will your child attend this year?*
Does your child receive free or reduced lunch? (We use this information for data during grant submissions)
Emergency Contact *
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
In case of an emergency for which we have to contact EMS, which hospital would you like for us to transport your child? (Please see Medical Care Waiver below)*
Is there anything we should know about your child? (allergies, medications, asthma, physical limitations or accommodations etc. if not please type N/A) *Please note that we do not administer medications to youth**
Does your child have special learning needs that we need to be aware of? (If not, please type N/A)*
How will your child arrive at our center?
List any family members or adults 18 years or older authorized to pick up your child. *We will NOT release your child to any adult who is not listed here*
Waivers and Releases

Please read the following documents and acknowledge by signing below
Parent Agreement & Program Policies

Liability Waiver

Medical Authorization

Behavior Expectations

Photo and Social Media Release
By enrolling my child in BrainyBuilders STEM Hub programs, I acknowledge that I have read, understand, and agree to all enrollment forms and policies, including the Parent Agreement & Program Policies, Liability Waiver, Medical & Emergency Care Authorization, Student Behavior Expectations, and Photo, Video and Social Media Release. I understand that participation involves hands-on STEM activities and inherent risks, that all fees are non-refundable, and that BrainyBuilders reserves the right to modify or cancel programs as needed. I authorize BrainyBuilders STEM Hub and its staff to provide emergency medical care if necessary, agree to uphold behavior and safety expectations, and grant permission for my child’s image to be used for educational and promotional purposes unless otherwise indicated below. By submitting this enrollment, I accept full responsibility for my child’s participation and consent to all terms and conditions.
I GRANT PERMISSION for BrainyBuilders to use photographs, videos, and other media involving my child(ren) for promotional, marketing, or educational purposes, including but not limited to, websites, brochures, social media platforms, and other public relations materials. I understand that these materials may be used in both print and digital formats.I DO NOT GRANT PERMISSION for BrainyBuilders to use photographs, videos, or any other media involving my child(ren) for promotional, marketing, or educational purposes, including but not limited to, websites, brochures, social media platforms, or other public relations materials.
Acknowledgement of Waivers & Expectations

First NameLast Name
Camps & Classes

Information

Week-long classes (information)
- ALL classes are from 9am-2pm (except Tinkerers')
- Tiny Tinkerers' class will only operate from 9a-12p, Tues-Friday
- All other week-long camps/classes operate from 9a-2p,Tues - Friday. Fees are per week. You may register for more than one class. Just remember to indicate number under the quantity.
- Lunch: If attending a week long camp, students will need to bring their own lunch. Healthy snacks, friut, and bottled water will be provided by BrainyBuilders staff. Lunch time - 45 min.
- There will be no outside play. Students will have open play times inside center (Legos, Kinex, board games, puzzles, Blooket, GoNoodle, etc.) will be provided for students to interact with. This is to allow for break breaks.
- Students earn 10 BrainyBucks for week and receive a free BrainyBuilders tee on last day of class. BrainyBucks can be redeemed for prizes at our BrainyStore.
- If attending a Saturday Discovery camp, students earn 3 BrainyBucks for that day.
Codebreakers: The Forensic Files Lab - June 23-26 Ages 11-13, Max 10WildMinds: Animal & Insect Explorers - June 30 - July 3, Ages 8-10, Max 10PixelPioneers: Video Game App Creators - July 7-10, Ages 8-11, Max 10BrickBosses: Lego Engineering Lab - July 14-17, Ages 8-11, Max 10TinyTinkerers' Lego Lab - July 21-24, (Note time: 9am-12pm), Ages 5-7, Max 8PixelPioneers: Video Game App Creators - July 28-31, Ages 12-14, Max 10
Jurassic Juniors: A Paleontology Club - June 6, Ages 5-7 (max 8)Motion Commotion: A Physics Lab - June 20, Ages 8-11 (Max 10)Star Seekers: Astronomy Adventurers - June 27, Ages 8-11 (Max 10)Code Sparks: Micro:bit Inventors Lab - July 18, Ages 8-11 (Max 10)Green Thumbs: The Science of Plants - July 25, Ages 8-11 (Max 10)

My Products*

Camp Fee/class (Tues-Fri)

This fee applies to the following: CodeBreakers, WildMinds, PixelPioneers, & BrickBosses

$290.00 Quantity

Camp Fee 1/2-day (Tues-Fri)

This fee applies to TinyTinkerers only

$220.00 Quantity

Camp Fee Discovery 1/2-day (Saturday)

This fee applies to 1/2 Saturdays only

$50.00 Quantity

Enter coupon

Total

$0.00

Credit Card Details
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BrainyBuilders 2026 Summer Camp Registration

Waivers and Releases