After School Program Registration - Winter 2021
Parent`s Last Name:
Parent`s First Name:
Parent`s Phone Number
This will be used for important updates and communication regarding the current session.
Student's Last Name
Student's First Name
School Student Attends:
Student's Grade in School:
Other: Please contact us for approval
Select the Program you are registering for:
Girls Science (Mon & Wed)
Girls Coding (Tue & Thu)
Boys Science (Mon & Wed)
Boys Coding (Tue & Thu)
How did you hear about our program? (Please select all that apply)
Aneinu Community E-mail
E-mails from Walder Science
Flyers in Shuls
Friends or Family
The Voice of Chicago Email Blast
Questions or Comments:
After clicking submit, you will be prompted to make an online payment.
The cost for each program is $52 for the first 4 weeks, or $128 for all 11 weeks of the winter sessions. Monthly payment plans available. Siblings join for half price.
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This form was created inside of Walder Science Center.