3D Modeling After School Program Student Registration
Please complete the following form to sign up for Silver Beach Elementary School After School Programs
3D Modeling | TUE / 2:45-4PM | 4th-5th | May 1 - May 29
Welcome to 3D Modeling by Dauntless Design Works!

Classes are on Tuesdays from May 1 through May 29nd.

This class is suitable for Grades 4 through 5, and is capped at 15 students. If you have a particularly focused 3rd-grader who is interested, please contact the instructor.

A minimum number of 7 Students must register for this class to be offered.

This class is offered by:

Jason Davies, Dauntless Design Works. jason@dauntlessdesignworks.com, 360-820-4187.

Tuition is $60, Please submit a check made out to Jason Davies in your child's student folder.

If you have any questions or problems using this form, please email sbea.enrich@gmail.com. Thank you.

Student Information
First Name *
Your answer
Student Last Name *
Your answer
Grade Level *
Classroom Teacher
Your answer
Parent / Guardian Information
Parent / Guardian Name *
Your answer
Phone Number *
Your answer
Alternate Phone Number
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Email
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Parent / Guardian #2
Parent / Guardian #2 Name
Your answer
Phone
Your answer
Email
Your answer
Emergency Contact / Pickup Person
Name *
Your answer
Phone *
Your answer
Emergency Contact / Pickup person #2
Your answer
Phone Number for Contact / Pickup #2
Your answer
Pickup Plans and Policy
Pickup Plans *
Your answer
"The PTO enrichment pickup policy states that if a student is picked up late (over 5 minutes after class ends) more than once, then that student could be removed from class, without a refund. Instructors may use their discretion to deviate from this policy, as long as the instructor provides the extra adult supervision time. This extra time, for possible late pickups, needs to be understood and agreed upon between the families and the instructors." *
Select 'Agree' to indicate that you understand and agree with the PTO enrichment pickup policy above. Otherwise, if you 'Disagree', please explain in the comments.
Comments
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Allergies / Medications
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Does the student have a Life-Threatening Allergy?
LTA Information
Parents of students with necessary medications (Epi-Pens, rescue inhalers etc.) will need to make separate arrangements before starting these programs. Medications used during normal 'school hours' will not be available.
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