Empowering Parents Grant: Class Registration
If you would like to use Empowering Parents Grant funds to pay for your student's class or camp at Gizmo, please fill out this form to do so. We will reserve their spot in the class and send you an invoice which you can submit to ClassWallet.
Child's Name
First Name
Last Name
Child's Date of Birth
-
Month
-
Day
Year
Date
Class or Camp
Please type the name of the class or camp you would like to register your child for. If you are registering for more than one class/camp, separate the names with commas.
Parent's Name
First Name
Last Name
Parent's Email
example@example.com
Parent's Phone Number
Please enter a valid phone number.
Please list any allergies, medical conditions or limitations on activities:
Does your child have any unique needs or behaviors our staff should be aware of?
Individuals authorized to pick up child from Gizmo:
If child is 12 or older: Is your child authorized to sign themselves out?
Yes
No
Submit
Should be Empty: