FALL REGISTRATION

Register for La Jolla Elementary
Beginner Robotics

Complete one registration form for each participating engineer. After submitting the form, you’ll be directed to complete payment for the Fall Trimester.

LJES Beginner Robotics

Fall Registration

Day: Thursdays

Time: 3:00-4:00 PM

Location: LJ Elementary MakerSpace

Cost: $400

12 weeks: 8/20/26-11/5/26

Engineer's First name

Engineer's Last name

Engineer’s grade level

How many LJCR (La Jolla Cluster Robotics) trimesters has your engineer completed?

No previous trimesters

1 completed trimester

2 or more completed trimesters

Adult Contact 1 — First and Last Name

Adult Contact 1 Relationship to Engineer

Adult Contact 1 Email

Adult Contact 1 Phone

Adult Contact 2 — First and Last Name

Adult Contact 2 Relationship to Engineer

Adult Contact 2 Email

Adult Contact 2 Phone

Program Rules & Expectations

Please review the After-School Program Rules and La Jolla Cluster Robotics (LJCR) Program Expectations (below) with your engineer before submitting this registration.

LJCR Expectations

Robotics has the privilege of operating on the LJES campus, and our engineers are part of the school community. The same standards for behavior, respect, responsibility, and safety that apply during the school day also apply during LJCR activities.

Engineers are expected to:

Arrive on time and be ready to participate.
Focus on Robotics during program time. Robotics is not intended for completing homework, playing unrelated computer games, or participating in unrelated activities.
Participate actively and make productive use of Robotics time.
Respect teachers, coaches, fellow engineers, equipment, and the classroom.
Work collaboratively and contribute positively to the group.
Follow all safety expectations when building, coding, testing robots, and using equipment.
Demonstrate appropriate behavior while participating in LJCR activities and representing LJES and LJCR.

I confirm that I have reviewed the After-School Program Rules and LJCR Program Expectations with my engineer, and we understand and agree to follow them.

I understand that repeated or serious behavior or safety concerns, including failure to follow LJCR or La Jolla Elementary School expectations, may result in my engineer being removed from the program.

Parent Permissions & Acknowledgments

Allergies & Medical Information:

Please list any allergies, medical conditions, medications, or other health or safety information LJCR should be aware of while your engineer is participating in Robotics.

If none, you may leave the section blank.

Optional

I authorize LJCR staff to contact emergency services if necessary in the event of an illness, injury, or emergency involving my engineer. I understand that every reasonable effort will be made to contact a parent/guardian or emergency contact.

Photo & Media Permissions:

LJCR occasionally photographs or records program activities, projects, competitions, and events for the LJCR website, program communications, and program flyers. Photographs may also be shared with the LJES Yearbook for inclusion on the Robotics yearbook page.

May LJCR and the LJES Yearbook use photos or videos that may include your engineer?

Yes, I give permission for both LJCR and the LJES Yearbook.

I give permission for the LJES Yearbook only.

No, I do not give permission.

Participation and Safety Acknowledgment:

I understand that robotics activities involve the use of robotics equipment, LEGO® components, computers, moving robots, and other classroom materials. I understand that engineers are expected to follow all safety instructions and use equipment appropriately.

Parent/Guardian Digital Signature:

Please type your full legal name below.

By entering your name, you acknowledge that you have read, understand, and agree to the La Jolla Elementary After School Rules and La Jolla Cluster Robotics program expectations and acknowledgments included in this registration.

I understand and acknowledge the participation and safety expectations above.

Parent/Guardian Full Legal Name

Date

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This is a checkbox.