After School STEAM Class – STEAMULATION LAB

Email *

Child's First Name *

Child's Last Name *

Child's Date of Birth *

Child's School Grade *

Gender *

What time would you like to register? *

Mondays : 3:30-5:30PM: $180/4 sessionsThursdays: 3:30-5:30pm: $180/4 sessionsBoth Mondays & Thursdays: 3:30-5:30pm: $320/4 sessions

How many people will be participating? *

Please Describe any Food Allergies or Dietary restrictions *

Parent/Guardian's Full Name *

Parent/Guardian's Phone Number *

Address *

Do you want to be notified about upcoming programs?

I give permission for my child to be photographed or recorded during STEAMULATION Lab activities for educational and promotional purposes, including the website and social media. *

To secure your booking, please proceed with the payment. Once your payment has been successfully processed, you will receive a confirmation email from PayPal.

Please use a laptop or desktop computer to complete your registration, as the registration form may not work properly on a mobile device.

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