Home
Programs & Camps
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Science Fun!
STEM After School Registration
ONLINE REGISTRATION FORM
About
KIDDOS
Contact Information
STEAMTastic Moments
Home
Programs & Camps
Schools Out Camp
Science Fun!
STEM After School Registration
ONLINE REGISTRATION FORM
About
KIDDOS
Contact Information
STEAMTastic Moments
Registration
ONLINE REGISTRATION FORM
First Child Name
*
First Name
Last Name
Child Name (2)
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Gender
*
Female
Male
Gender (Child 2)
*
Female
Male
Age
*
Age (Child 2)
School Name
*
If children are at different schools, please list both schools
First Parent/Guardian Name
*
First Name
Last Name
Second Parent/Guardian Name
First Name
Last Name
Address - (if different)
Second Parent/Guardian address can be listed in this section
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent Email Address
*
Email (2)
Phone - First Parent/Guardian
*
Phone - Second Parent/Guardian Name
Work Phone - First Parent/Guardian
Work Phone (2)
First Emergency Contact Name
*
First Name
Last Name
Emergency Contact Name (2)
*
First Name
Last Name
Emergency Contact Phone
*
Emer. Contact Phone(2)
*
Emergency Contact Type
*
Emergency Contact Only
Pick Up Only
Both
Emer. Contact Type (2)
*
Emergency Contact Only
Pick Up Only
Both
Thank you!
