Registration HACK@CODE (Private Teams) November 2021 *Please submit another form if you are registering more than 3 teams. Adult / Teacher / Coach *SalutationMrMsMdmMrsName *FirstLastYour Email *PhoneAddress *Address Line 1CityState / Province / RegionNumber of Teams *123Team 1: Name *Team 1: Member 1 *Date of Birth (Member 1) *School *Team 1: Member 2Date of Birth (Member 2)School (copy)Team 1: Member 3Date of Birth (Member 3)School (copy) (copy)Team 2: Name *Team 2: Member 1 *Date of Birth (Member 1) *School (copy) (copy) (copy) *Team 2: Member 2Date of Birth (Member 2)School (copy) (copy) (copy) (copy)Team 2: Member 3Date of Birth (Member 3)School (copy) (copy) (copy) (copy) (copy)Team 3: Name *Team 3: Member 1 *Date of Birth (Member 1) *School (copy) (copy) (copy) (copy) (copy) (copy) *Team 3: Member 2Date of Birth (Member 2)School (copy) (copy) (copy) (copy) (copy) (copy) (copy)Team 3: Member 3Date of Birth (Member 3)School (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy)Any member done coding before?YesNoHow did you learn about HACK@CODE? *Tribal StudiozCode.JAMFacebookInstagramFamily/FriendsOthersOthers *HACK@CODE (Private) 1 TeamPrice: $ 30.00HACK@CODE (Private) 2 TeamsPrice: $ 60.00HACK@CODE (Private) 3 TeamsPrice: $ 90.00HACK@CODE (Private) specialPrice: $ 1.00Credit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2223242526272829303132PhoneSubmit