Saturday/Girls' Science Club 2023- Initial Intake Form
The next Saturday Science Club session will be on June 3rd.
Email Ms. Steph,
, with questions.
3.5 to 10 years of age
Saturdays, 12 to 3 pm (
Girls' Club is on
, 2 to 4:30 pm
Shugah Baybees Child Development Center, 138th btwn ACP Jr Blvd & Lenox Ave
This form is an
and RSVP form. If you have ALREADY completed this form please use,
to RSVP for additional Saturday Science Club sessions in 2023.
Visit our website,
, to learn more about us.
Sign in to Google
to save your progress.
* Indicates required question
Full Name of YOUTH PARTICIPANTS. Please list all children that will be participating in the session.
Current Age of Youth Participant(s).
The youth participant(s) is/are
number of ADULT COMPLETING THE FORM
For the adult completing the form: What is your relationship to the child?
What are your family's identifiers? Please share any cultural, ethnic, or religious that you would like to communicate with us.
Note: This question is NOT mandatory.
YOUTH PARTICIPANT'S Zip Code
Emergency Contact Information- List the
of people OTHER than yourself who are authorized to pick-up the youth participant or who can be contacted in the case of an emergency.
How did you hear about Ms. Steph's Science Club?
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