2019 Fall Session Registration

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FALL SESSION (Grades 2 - 8)
After-school & Saturday Program

MONDAY (4:00pm - 6:00pm)  |  $80/student
Labs: Coding, Engineering, Marine Biology, Physics
(Classes held September 23 - December 2, No Class on November 11)

THURSDAY (4:00pm - 6:00pm)  |  $80/student
Labs:
Coding, Engineering, Marine Biology, Physics
(Classes held September 26 - December 5, No Class on November 28)

SATURDAY AM (9:00am - 12:00pm)  |  $125/student
Labs:
3D Printing, Botany, Climate Science, Coding
(Classes held September 28 - December 14, No Class on November 9 & 30)

SATURDAY PM (1:00pm - 4:00pm)  |  $125/student
Labs:
3D Printing, Botany, Climate Science, Coding
(Classes held September 28 - December 14, No Class on November 9 & 30)


Sibling discount available and will be automatically applied.

NEW: Registration now includes participation information and waiver of liability.

PARENT/GUARDIAN INFORMATION












This program is located in San Diego, CA ONLY
SCHOLARSHIP REQUEST

Scholarship application period has closed on Monday, September 2, 2019 at 11:59PM. Applicants will be notified of their status by Monday, September 9, 2019.


We encourage you to check our website regularly for future scholarship opportunities.

SCHOLARSHIP REQUEST
SCHOLARSHIP APPLICATION


My household income is $
per year.
STUDENTS

STUDENT 1




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STUDENT 2




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STUDENT 3




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STUDENT 4




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STUDENT 5




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AUTHORIZED ADULTS FOR PICK-UPS
Please provide the authorized adult(s) first name, last name, and phone number.






TEMPORARY MEDICAL AUTHORIZATION
By enrolling my child(ren) to attend Fall Session at the Elementary Institute of Science (EIS), I, the parent/guardian, give EIS permission to act on my behalf in case of a medical emergency for my child(ren) while participating in the program.
EMERGENCY CONTACTS






MEDICAL INFORMATION





 
DONATION (OPTIONAL)

FALL SESSION SUBTOTAL
$
SCHOLARSHIP APPLICATION FEE
$
This amount will be refunded if your student(s) are not awarded a scholarship.
DONATION SUBTOTAL
$
TOTAL PRICE
$
IMPORTANT PROGRAM INFORMATION
Changing Sessions after Registering
If there is space available, there will be a change fee of $20 per student to accommodate this request.

Cancellation Policy
Cancellation and refund will be issued based on when EIS is notified of cancellation, prior to start date.
  • 1 month or more = Registration fee minus $20 processing fee per student per session
  • Less than 1 month prior to program start date = 50% refund
  • Less than 2 weeks prior to program start date = 25% refund
  • Less than 1 week prior to program start date = No Refund

Waiver of Liability
By enrolling my child(ren) in this program, I hereby give permission for them to participate in all the various activities, including field trips, of the Elementary Institute of Science (EIS). EIS does not assume financial or legal liability in case of injury or accident. I hereby waive all claims against the Elementary Institute of Science, its Board, employees, and volunteers for injury, accident, illness or death that may occur while participating in EIS programs.

Media Release
By enrolling my child(ren) in this program, with the Elementary Institute of Science (EIS), I, the parent/guardian, agree to authorize EIS to photograph, videotape, film, or quote my child(ren). I authorize the EIS to permit the use and the publication of any photographs, videotape, or film of my child(ren) for publicity purposes, including release of such photographs, videotape, film or quotes, to the news media and on the EIS website. I agree to hold harmless the Elementary Institute of Science, its officers, agents, and employees from any liability resulting from, or arising in connection with, the taking, publication, and release of the photographs, videotape, film or quotes of the student(s) in this agreement.
CREDIT CARD





Comments/Notes for EIS (Optional)

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