Afterschool - Woodsy Wild/

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Science Scout's Name:

First

Last

Please enter name of child you are enrolling in Science Scout classes

Date of Birth:

Name of School:

Parent's Name:

First

Last

Email:

Phone:

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Class Selection:

Date your child is able to start:*

*The Fall Afterschool Session starts on Sept. 9th. Please note if your child will be starting on a different date.

Name:

First

Last

Phone:

Card Name: Email:

Allergy/Medical Concerns:

Please note any allergies or medical concerns that you would like us to be aware of.

Registration Fee: $200

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