Clone of Game Coding Camp Summer 2026

Local relatives/friend who will be responsible for your student should he/she become ill and you cannot be reached.
Emergency Contact 1
Full Name

First NameLast Name
Relationship to Student
Primary Number
Format: (000) 000-0000.
Secondary Number
Format: (000) 000-0000.
Emergency Contact 2
Full Name

First NameLast Name
Relationship to Student
Primary Number
Format: (000) 000-0000.
Secondary Number
Format: (000) 000-0000.

Physical and Medical Information
Doctor's Name

PrefixFirst NameLast Name
Doctor's Number
Format: (000) 000-0000.
Please list any of the following: Current medications, medication allergies, food allergies, or chronic health concerns.

PLEASE NOTE:

Session registration closes at midnight on Friday before the session is set to start.
Please inform the office of any other vital information you think we may need to know.
Nondiscrimination Statement: Technology Center of DuPage extends equal opportunity in the areas of admissions, educational programs, activities, and employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, marital status, disabled status or age.
PaymentName
PaymentEmail
Session1
CurrentYear
Should be Empty:

Student Information