Your info

First name *

Email *

Last name *

Phone *

Your Child's Info

Child's first name *

Child's Date of Birth *

Child's last name *

Class *

Emergency contact name *

Emergency contact phone *

Emergency contact relation *

Medical and/or Social Conditions

Medications

Allergies

Thank you for registering for Big Idea Machines. Look for a follow up email in the coming days with next steps and payment information.

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