Before and After school Extreme Science registration form

Before and After school Extreme Science registration form
School name*
Child's first name*
Child's Last name*
Child's Teacher (enter Teachers LAST NAME only)*
Child's grade?*
Are there any health concerns?*
Parent name(s)*
Email*
example@example.com
best number to TEXT confirmation info*
Please enter a valid phone number.
First contact number*
Please enter a valid phone number.
Alternate contact number
Please enter a valid phone number.
additional contact number
Please enter a valid phone number.
How would you like us to release your child at the end of class?*
Preferred day (or days) **Please refer to the registration form your child brought home to see which day(s) the program is being offered at your school.*

MondayTuesdayWednesdayThursdayFriday
If your first choice class is full, which other days are you available? Check all that apply.

MondayTuesdayWednesdayThursdayFriday
Comments?
Do NOT send payment to the school. Payments are due on the FIRST DAY of class. You will receive a confirmation TEXT message approximately one week before the first class from phone number (833) 446-0834. Please add this number to your contacts now.*

Please read the statement above and click to confirm
Should be Empty: