Budding Naturalists Registration 2019 - 2020
REGISTRANT INFORMATION
Child's Name *
Your answer
Address *
Your answer
Gender *
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? *
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. *
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