Super Science Sunday Nursery/Kindergarten Registration: Winter 2018-19
Parent Last Name: *
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Parent First Name: *
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Parent Phone Number *
The phone number of a parent who we should call in an emergency (Parents must be available and reachable during their children's class).
Your answer
Emergency Phone Number: *
A number in case a parent cannot be reached
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School(s) Your Children Attend: *
Please list the elementary and/or middle schools attended by registrants.
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Email Address: *
This will be used for important updates and communication regarding the current session.
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How did you hear about our program? *
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10:15am-11:30am Class
Skip this section if you are signing up for the 1:45-3:00pm session
First Names of Participants
Your answer
Grades in School of Participant:
Check all that apply.
Choose all the dates that your child will be attending the program.
Feb 3rd
Feb 10th
Feb 17th
Feb 24th
Mar 3rd
Mar 10th
Mar 17th
Mar 24th
Mar 31st
1:45pm-3:00pm Class
Skip this section if you are not signing up a child for the 1:45-3:00pm session.
First Names of Participants
Your answer
Grades in School:
Check all that apply
Choose all the dates that your child will be attending the program.
Feb 3rd
Feb 10th
Feb 17th
Feb 24th
Mar 3rd
Mar 10th
Mar 17th
Mar 24th
Mar 31st
Questions or Comments:
Your answer
After clicking submit, you will be prompted to make an online payment.
Each Sunday Program is $12 per child or $102 for all nine Sundays.

Discounts for multiple children enrolled:
$198 for all nine Sundays for two children
$294 for all nine Sundays for three children

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