Registration 

Please complete this form to register your child for any of our eSTEAM Club Programs. Completing this form provides us with the information we need for your child(ren) to safely participate in any of our programs.  Once you have completed the registration form, click on the Home tab at the top of webpage to purchase your child's program ticket. Tickets must be purchased before your child can join us for any program. You can purchase tickets for multiple programs or weeks of one program in advance.

Select Program*

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Parent/ Guardian Information

Parent/Guardian Name

Contact

Address

Child 1 Information

Child Name *

Date of Birth

School Information

Teacher's Name

List All Individuals Authorized To Pick Up 

Medical Information

Please list allergies/medical conditions. List any daily medications your child takes. This information is private and only used in case of emergencies.

Child 2 Information

Child Name *

Date of Birth

School Information

Teacher's Name

List All Individuals Authorized To Pick Up 

Additional Information

Please list allergies/medical conditions. List any daily medications your child takes. This information is private and only used in case of emergencies.

Child 3 Information

Child Name *

Date of Birth

School Information

Teacher's Name

List All Individuals Authorized To Pick Up 

Additional Information

Please list allergies/medical conditions. List any daily medications your child takes. This information is private and only used in case of emergencies.

Additional Emergency Contact

Contact Name

Relationship

Phone Number