Summer Camp Registration Form

ATTENTION PARENTS:

If your child's school is closed due to weather, the Corona virus, or any other circumstances out of our control, the Extreme Science class will NOT be held that day. We will do everything we can to make these classes up. Due to our schedule with other schools and programs, this may not always be possible. No refunds are given (full or partial) due to school closures out of our control.

ATTENTION PARENTS:

Tell me and I forget

Teach me and I remember

Involve me and I learn

- Benjamin Franklin

Extreme Science is taking this Summer off to work on other projects and will NOT be offering Summer camps for 2017. Please check back next year or send us a message to be placed on our waiting list. Thank you and have a GREAT Summer.

PLEASE NOTE: Internet Explorer users - For some unknown reason, Internet Explorer is not working with our registration form. Firefox seems to be working just fine. If you experience problems, you can email your registration information to rd_272@msn.com or call us at 509-892-7621 to complete your registration while we work on solving this issue. We apologize for any inconvenience.

Emergency Contact Cell Phone *

Emergency Contact Phone *

Secondary Emergency Contact Name: *

Emergengy Contact Cell Phone *

Emergency contact Phone *

Primary Emergency Contact Name: *

Cell Phone *

Work Phone *

Father's Name: *

Cell Phone *

Work Phone *

Mother's Name: *

T-shirt Size *

Doctor's Phone Number *

Child's doctor: *

Health Concerns *

Child's School

Age *

Birthdate:

Complete Address *

Child's Name: *

Choose Session *

Primary Email Address: *

Home Phone *

Comments/Questions:

Refund Policy

Mail check or money order to:
Extreme Science
10315 E. Desmet Ave.
Spokane Valley, WA
99206

$75 non-refundable deposit required.

Minimum 18 kids for each camp. If camp is cancelled for not enough kids registered, you will be notified approximately two weeks prior to camp start date. Any deposits received WILL be refunded if camp is cancelled.

Emergency contact information

(in case you cannot be reached)

Parent/

Guardian Information

Child's information