EmailMe Form - Hands on Science Registration for THREE Children

Parent Email *

Phone *

### - ### - ####

Parent Name / Contact Person *

First Last

Select school *

Checkbox *

Check box to register three children for $99.00

This price reflects a $11.50 sibling savings

Check lunch if desired

Optional Lunch for First Participant $3.50

Optional Lunch for Second Participant $3.50

Optional Lunch for Third Participant $3.50

You must check a box for each lunch you are ordering. Lunch is optional, you can bring money to buy lunch or bring a bag lunch from home. Pre-purchse of lunch saves you money

First Participant
Chid's Name *

First Last

First Participant
Child's Age *

First Child
FIRST CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
SECOND CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
THIRD CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
FOURTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
FIFTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
SIXTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
SEVENTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

First Child
SURPRISE SPECIALTY WORKSHOP *

Yes if available I would like my child to partipate

No thanks we will pass

From time to time we have a guest teacher with a class not on our list. if you would like your child to be selected to be a part of this "surprise" workshop check yes, if not check no.

Second Participant
Chid's Name *

First Last

Second Child
Child's Age *

Second Child
FIRST CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
SECOND CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
THIRD CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
FOURTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
FIFTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
SIXTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
SEVENTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Second Child
SURPRISE SPECIALTY WORKSHOP *

Yes if available I would like my child to partipate

No thanks we will pass

From time to time we have a guest teacher with a class not on our list. if you would like your child to be selected to be a part of this "surprise" workshop check yes, if not check no.

Third Child
Chid's Name *

First Last

Third Child
Child's Age *

Third Child
FIRST CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
SECOND CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
THIRD CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
FOURTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
FIFTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
SIXTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
SEVENTH CHOICE *

Unless noted all classes are for all ages and students will be in age appropriate groups.

Third Child
SURPRISE SPECIALTY WORKSHOP *

Yes if available I would like my child to partipate

No thanks we will pass

From time to time we have a guest teacher with a class not on our list. if you would like your child to be selected to be a part of this "surprise" workshop check yes, if not check no.

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Optional Tax Deductible Donation

$ Dollars . Cents