Ember & Root's Spark Club Application Form (2025-2026)
Once you’ve received notification, your child is admitted to Spark Club. Admission means you are committed only to the upcoming session.This application only needs to be completed once per school year. For future sessions you may want to join, you'll just sign up.
Child Information
Child's Full Name
*
First Name
Last Name
Age (As of September 16, 2025)
*
Date of Birth
*
-
Month
-
Day
Year
Gender:
Current School Attending
*
Child's Grade (2025-2026 School Year)
*
Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Session Preference
Preferred Day(s)- Select one or both
*
Tuesday
Thursday
About Your Learner
Tell us about a little your child's personality and interests:
*
Are there any special needs, diagnoses, or accommodations we should be aware of?
*
How Did You Hear About Us?
*
Friend / Word of Mouth
Social Media
Flyer or Poster
Other
Acknowledgments & Agreement
Read and select to acknowledge agreement.
*
I understand that Ember & Root is a self directed program, where children are invited to engage in interest based activities and programming. A child requiring constant assistance may not be a good fit for the program.
I understand that Ember & Root aims to be a diverse, mixed age learning environment, that celebrates diversity.
I understand that acceptance into the program cycle is based on space availability and alignment with the program's approach. We may follow up with a brief call to make sure Ember & Root is a good fit for your learner.
I understand that Ember & Root is an enrichment, extracurricular program. It is not a traditional childcare center or a tutoring center.
I understand the drop off time for The Spark Club is 3:30-3:45 PM and pick up time is 5:30-5:45 PM. We run the program in 6 week sessions. Every session will have fresh, new offerings. We welcome registrants to continue throughout the year as an extracurricular, if it fits their needs and schedule
*
Yes
No
Date
*
-
Month
-
Day
Year
Once we've reviewed your application, we will send you your permission forms and invoice. They must be submitted prior to first day of the program and invoice must be paid for finalized enrollment. (Good news: application and registration forms only have to be filled out once a year and cover all E&R programming)
I understand
Submit
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