Registration - The Coffin of Bela Lugosi - Brainchase

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Registration – The Coffin of Bela Lugosi

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Student 1
Student 1 Name*
First Last
Student 1 Date of Birth*
MM slash DD slash YYYY
Gender for Student 1*
- Male
- Female
- Rather not say
Product Name*
Select Programs for Student 1*
- 6/12 - 6/16: The Pirate's Gold
- 6/19 - 6/23: The Globe of Magellan
- 6/26 - 6/30: The Man of Steel
- 7/3 - 7/7: The Sunstone of Cortes
- 7/10 - 7/14: The Jungle Book
- 7/17 - 7/21: The Mask of Tomoe Gozen
- 7/24 - 7/28: The Lost World
- 7/31 - 8/4: Sherlock Holmes
- 6/19 - 8/4: The Globe of Magellan (GLOBAL TREAURE HUNT)
Student age*
- Ages 7-9
- Ages 11-12
Session Time*
- Monday - !2:00PM
- Monday - 2:00PM
- Monday - 4:00PM
Session Time*
- Tuesday - !2:00PM
- Tuesday - 2:00PM
- Tuesday - 4:00PM
Add Gear for Student 1
- Adventure Tools (decoder ring, brass compass, magic seeds)
- Academy Gear (t-shirt, poster, clue notebook)
T-Shirt Size for Student 1*
+ Get three Adventure Tools with the Explorer package!
+ Get three Adventure Tools, an official Brain Chase Clue Notebook, a program T-shirt, and a Brain Chase Poster with the Adventurer package!
Would you like to add a second student?
- Yes, add Student 2
Total
$0.00

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Student 2
Student 2 Name*
First Last
Student 2 Date of Birth*
MM slash DD slash YYYY
Gender for Student 2*
- Male
- Female
- Rather not say
Product Name*
Select Programs for Student 2
- 6/12 - 6/16: The Pirate's Gold
- 6/19 - 6/23: The Globe of Magellan
- 6/26 - 6/30: The Man of Steel
- 7/3 - 7/7: The Sunstone of Cortes
- 7/10 - 7/14: The Jungle Book
- 7/17 - 7/21: The Mask of Tomoe Gozen
- 7/24 - 7/28: The Lost World
- 7/31 - 8/4: Sherlock Holmes
- 6/19 - 8/4: The Globe of Magellan (GLOBAL TREAURE HUNT)
Student age*
- Ages 7-9
- Ages 11-12
Session Time*
- Monday - 2:00PM
- Monday - 2:00PM
- Monday - 4:00PM
Session Time*
- Tuesday - 2:00PM
- Tuesday - 2:00PM
- Tuesday - 4:00PM
Add Gear for Student 2
- Adventure Tools (decoder ring, brass compass, magic seeds)
- Academy Gear (t-shirt, poster, clue notebook)
T-shirt Size for Student 2*
+ Get three Adventure Tools with the Explorer package!
+ Get three Adventure Tools, an official Brain Chase Clue Notebook, a program T-shirt, and a Brain Chase Poster with the Adventurer package!
Would you like to add third student?
- Yes, add Student 3
Total
$0.00

Save and Continue Later

Student 3
Student 3 Name*
First Last
Student 3 Date of Birth*
MM slash DD slash YYYY
Gender for Student 3*
- Male
- Female
- Rather not say
Product Name*
Select Programs for Student 3
- 6/12 - 6/16: The Pirate's Gold
- 6/19 - 6/23: The Globe of Magellan
- 6/26 - 6/30: The Man of Steel
- 7/3 - 7/7: The Sunstone of Cortes
- 7/10 - 7/14: The Jungle Book
- 7/17 - 7/21: The Mask of Tomoe Gozen
- 7/24 - 7/28: The Lost World
- 7/31 - 8/4: Sherlock Holmes
- 6/19 - 8/4: The Globe of Magellan (GLOBAL TREAURE HUNT)
Student age*
- Ages 7-9
- Ages 11-12
Session Time*
- Monday - 2:00PM
- Monday - 2:00PM
- Monday - 4:00PM
Session Time*
- Tuesday - 2:00PM
- Tuesday - 2:00PM
- Tuesday - 4:00PM
Add Gear for Student 3
- Adventure Tools (decoder ring, brass compass, magic seeds)
- Academy Gear (t-shirt, poster, clue notebook)
T-Shirt Size for Student 3*
+ Get three Adventure Tools with the Explorer package!
+ Get three Adventure Tools, an official Brain Chase Clue Notebook, a program T-shirt, and a Brain Chase Poster with the Adventurer package!
Would you like to add fourth student?
- Yes, add Student 4
Total
$0.00

Save and Continue Later

Student 4
Student 4 Name*
First Last
Student 4 Date of Birth*
MM slash DD slash YYYY
Gender for Student 4*
- Male
- Female
- Rather not say
Product Name*
Select Programs for Student 4
- 6/12 - 6/16: The Pirate's Gold
- 6/19 - 6/23: The Globe of Magellan
- 6/26 - 6/30: The Man of Steel
- 7/3 - 7/7: The Sunstone of Cortes
- 7/10 - 7/14: The Jungle Book
- 7/17 - 7/21: The Mask of Tomoe Gozen
- 7/24 - 7/28: The Lost World
- 7/31 - 8/4: Sherlock Holmes
- 6/19 - 8/4: The Globe of Magellan (GLOBAL TREAURE HUNT)
Student age*
- Ages 7-9
- Ages 11-12
Session Time*
- Monday - 2:00PM
- Monday - 2:00PM
- Monday - 4:00PM
Session Time*
- Tuesday - 2:00PM
- Tuesday - 2:00PM
- Tuesday - 4:00PM
Add Gear for Student 4
- Adventure Tools (decoder ring, brass compass, magic seeds)
- Academy Gear (t-shirt, poster, clue notebook)
T-Shirt Size for Student 4*
+ Get three Adventure Tools with the Explorer package!
+ Get three Adventure Tools, an official Brain Chase Clue Notebook, a program T-shirt, and a Brain Chase with the Adventurer package!
Total
$0.00

Save and Continue Later

How did you hear about us?*
Parent Name*
First Last
Parent Email Address*
Enter Email Confirm Email
Parent Phone*
E-Signature*
By typing in your full name, you certify that the information in your registration is accurate and true.
If you have a coupon code, enter it here:
Total
$0.00

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Total
$0.00
Credit Card
Card Details
Cardholder Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
- Mailing Address is the Same as Billing Address
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
TREASURE HUNT RULES*
- I understand that only residents of 49 US states (excluding MD) and residents of Mexico, UK, Ireland and Canada (excluding Quebec) can enter the contest to win the treasure. All others are welcome to participate in the learning challenge but are ineligible to win.
- I understand that only students between the ages of 6-16 as of June 9, 2023 can enter the contest to win the treasure. All others are welcome to participate in the learning challenge but are ineligible to win.
Agreements*
- I agree to the Brain Chase Terms of Service and Privacy Policy.
- I agree to the Brain Chase Summer 2023 Contest Rules.

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