FLL Discover

FLL Discover

Use this form to enroll your student in one or BOTH Discover Session
FLL DISCOVER

This playful introductory STEM program ignites young students’ natural curiosity and builds
their habits of learning with hands-on activities
in the classroom using LEGO® DUPLO® bricks.

Ages: 4-6 years old
8 Weeks
Thursdays: Jan - Feb or Mar-April
Time: 5-6 PM
Cost: $40 per session
* No classMarch 26 for spring break

All classes will be held at The Kaleidoscope Discovery Center: 609 N. Rolla St. Rolla, MO
Program Selection
Your Name (person completing this form)

First NameLast Name
Your Email
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Your Phone Number
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Your Address

Street Address

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Student Name

First NameLast Name
Student Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student's Age
This event is only for students ages 4-6 years old.
Student's phone number (if different than the one you listed for yourself)
Please enter a valid phone number.Format: (000) 000-0000.
Student's address (if different than the one you listed for yourself)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Additional Emergency Contact Name

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Student's Additional Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student's Additional Emergency Contact Email
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If this student has any allergies, needs special accommodations, or if there is anything else we should know, please list it below.
May we use photos of this student for our marketing purposes?
Total Owed (read-only field)
How are you paying for your student to attend?
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FLL Discover

Pay on PayPal or with Credit Card (no PayPal account required)