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Put on your lab coat and get ready for a day of hands-on discovery! We’ll be experimenting with swirling color jars, bringing science to life in the most vibrant way. Get ready to mix, create, and maybe even get a little messy—because that’s what science is all about!

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Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:*	Cell #: Work #:
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	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info*

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
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	Primary Doctor's Name & Phone # & Date of Last Exam:*
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