Registration Form
Register for our virtual STEM & Fitness Academy below. Once completed, make your payment to confirm your child's spot.
* Required
Email address
*
Your email
Student's first and last name:
*
Your answer
Guardian's first and last name:
*
Your answer
Student's age:
*
Choose
7
8
9
10
11
12
Student's grade:
*
Choose
2nd
3rd
4th
5th
6th
7th
8th
What school does your child attend?
*
Your answer
Which city and state do you reside?
*
Your answer
Has your child been exposed to STEM?
*
Yes
No
A little
Which sessions would you like to reserve?
*
Please select all that apply. Payment is required to confirm your spot! The Paypal link is located on the website.
12 pm- 2 pm
N/A
Saturday, April 3, 2021- Circuitry
Saturday, April 17, 2021- Circuity #2
Saturday, May 1, 2021 Horticulture
Saturday, May 15, 2021 Horticulture #2
12 pm- 2 pm
N/A
Saturday, April 3, 2021- Circuitry
Saturday, April 17, 2021- Circuity #2
Saturday, May 1, 2021 Horticulture
Saturday, May 15, 2021 Horticulture #2
How would you like your supplies distributed?
*
Delivered to your home (Amazon)
Pick-up (Chicagoland area)
Access to a computer & internet are required to participate. Will your child have access to the necessary supplies?
*
Yes
No
I need assistance
Does your child have fitness restrictions? If no, type n/a.
*
Your answer
Any other comments and/or questions?
Your answer
A copy of your responses will be emailed to the address you provided.
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