Adult Tech Registration

Please complete this form to register for an upcoming session.

Student Information

Name

Birthday

Month

Day

Year

Email

Phone

Address

Gender

Female

Male

Prefer not to say

Emergency Contact

Emergency Contact Name

Relationship To Student

Emergency Phone Number

Email

Health & Safety

Do you have any allergies, medical conditions, or accessibility needs (e.g., vision, hearing, mobility) that we should be aware of to ensure a comfortable learning experience?

No

Yes (please explain below)

List of allergies or medical conditions

Camp Session Selection

Smartphone Savvy (iPhone Edition): June 2 - June 13

E-Store Entrepreneurs: June 16 - June 27

Adult Drone Discovery: July 7 - July 18

Social Media & Digital: Communication: July 21 - August 1

Digital Literacy Bootcamp: August 4 - August 15

Smartphone & Tablet Mastery: August 18 - August 29

Smart Home & Everyday Tech: August 25 - September 5 (Note: Includes Labor Day week)

Tech It Easy (Individual) Sessions every other week

Camp Session Selection

Summer Explorer (1 Week) 9a-3p

Summer Explorer (2 Week) 9a-3p

Student Experience & Interests

Have you attended a Adult Tech camp before?

Yes

No

What interests you most about this particular tech camp

Acknowledgments

Check boxes to acknowledge and agree to the following:

I have read and agree to the Enrollment Policy and Cancellation Policy.

I have read and agree to the Adult Tech Waiver

5. Photography & Media Release

I grant permission for my image or likeness to be photographed, recorded, or used in promotional materials, publications, or online platforms by the Foundation to promote its programs.

Yes

No

Select the start date of your desired Adult Tech Camp

Choose Your Camps Date

Payment

Choose Your Payment Method:

Credit/Debit Card

Scholarship Application

School Sponsor

Private Sponsor

Signatures

Name

Date

Month

Day

Year

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

You will receive a confirmation email with camp location details after your enrollment is processed completely. For questions, contact us at info@techtimecincinnati.net or 513-443-5144

Check To Verify

Tech It Easy With Us!