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Budding Naturalists Registration 2019 - 2020
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REGISTRANT INFORMATION
Child's Name
*
Your answer
Address
*
Your answer
Gender
*
Female
Male
Child's Birthdate
*
Your answer
FAMILY INFORMATION
Parent/Guardian's Name
*
Your answer
Relationship to Child
*
Your answer
Primary Phone Number:
*
Your answer
Secondary Phone Number:
Your answer
Work Phone Number:
Your answer
Email Address:
*
Your answer
Additional Parent/Guardian's Name:
Your answer
Relationship to Child:
Your answer
Primary Phone Number:
Your answer
Secondary Phone Number:
Your answer
Work Phone Number:
Your answer
Email Address:
Your answer
PROGRAM SELECTION
Which day(s) are you interested in registering for?
*
Monday
Wednesday
Required
A $50 non-refundable registration fee is required to hold your child's spot. You will receive a welcome e-mail following completion of this form. Monthly Tuition is due by the last day of prior month. October Tuition is due by September 30. Please contact Kimberly Adriaansen at
kadriaansen@sciencebuff.org
or 896.5200 x 200 with any questions.
*
Yes, I agree to pay the registration fee and understand the tuition payment schedule.
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