STEM Program – Parent/Guardian Sign-Up Form
Thank you for your interest in enrolling your child(ren) in our STEM Program. Please complete this form so we can match your child with the right learning opportunities.
Parent/Guardian Information
Full Name
*
First Name
Last Name
Relationship to Child(ren):
*
Phone Number
*
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child(ren) Information
Child’s Full Name:
*
First Name
Last Name
Age/Grade:
*
School:
*
(Add additional children as needed)
Program Interests (check all that apply):
Science & Engineering
Computer Programming & Coding
Robotics & Automation
Math Enrichment
Technology & Digital Literacy
Business & Entrepreneurship
Program Formats Interested In:
Summer Camps
Track-Out Camps
Afterschool Programs
Weekend Classes
In-School/Community-Based Classes
Support Needs
Does your child have any allergies, medical needs, or special accommodations?
Do you need support with transportation, meals, or technology access?
Consent & Agreement
I, the undersigned, give permission for my child(ren) to participate in the Inspired Now Networks STEM Program. I understand that staff and volunteers will take all reasonable precautions to ensure safety. I agree to be contacted with program details and updates.
Submit
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