Hands-On Learning Services
Summer Science Program 2012
Registration Form
Directions: Please fill out this from completely and click the "submit" button at the bottom of the page. You will be directed to the payment page after submitting your registration information
Child's Name: LAST, FIRST
Child's Age
Child's grade (N/A, PK, K, 1)
Parent/Guardian Name (please provide first and last)
Parent/Guardian Email Address
Parent/Guardian Phone number
Alternate/Cell Phone Number
Please provide the NAME and PHONE NUMBER of an EMERGENCY CONTACT that we should call in case we cannot reach the parent/guardian listed above.
Emergency contact name
Emergency contact phone number
If you will not be dropping off or picking up your child from summer science, please indicate below the name and phone number of the person who will be doing so
Name of drop off/pick up person
Phone number of drop off/pick up person
Health Information
Does your child have any food allergies or other health concerns (physical, behavioral, emotional, etc) that we should know about?
If yes, please explain below.
It is our policy that all medications- prescription and/or over-the-counter- must be administered at home. We will not administer or permit on the premises prescription or over-the-counter medications at Fantastic Friday Science. The only exceptions are emergency medications such as epi pens and athsma inhalers.
Medication Policy
I have read, I understand, and will adhere to the medication policies outlined above.
Photo release
Hands-On Learning, LLC, has my permission to take photos of my child during Summer Science and to post the photos on the company website
Special Instructions & Requests please enter if applicable
To complete registration, please click the submit button below. After submitting, you will be directed to the payment page to complete the process.
I, as parent/guardian of the above referenced child/children, give my permission for my child to participate in Summer Science. Further, I understand, agree to, and accept the policies of Hands-On Learning Services, with the understanding that neither the facilitators of this event nor Annapolis Recreation and Parks are responsible for lost articles or injury.
Signed,
(parent/guardian)
Costs and fees schedule
The cost for each child to attend the Summer Science program is $180, payable online after clicking the "submit" button above.
Additionally, a $20 materials fee is due for each child registered. These fees can be paid directly to the instructor at the time of check-in on the first day of camp.
Sessions Registered:
