2019 Programming & Electronics After School Registration Form
Fairbanks Museum & Planetarium STEM Lab Registration for Programming & Electronics After School with Geoff & Ethan Spence, starting September 25 from 4-6pm
Student's Last Name
Your answer
Student's First Name
Your answer
Student's Date of Birth
Your answer
Student's Email is applicable
Your answer
Parent or Guardian's Full Name
Your answer
Parent or Guardian's Email
Your answer
Home Address
Your answer
Home Phone Number
Your answer
Emergency Contact Person
Your answer
Emergency Contact's Phone Number
Your answer
How would you prefer to be contacted for billing? (Please make out checks to the Fairbanks Museum & Planetarium)
Any other information we should know about your child?
Your answer
Photography or Video Recording
First Aid
Authorization of Treatment
Release Statement
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