Community Homeschool Investigators of the River Park
(CHIRP) Program Registration Form
Please refer to our
CHIRP Themes & Pricing Sheet
for more information on monthly series themes, session dates, and pricing options for program fees.
Discounts and Purchase Orders will be applied at checkout.
Guardian/Caregiver Information
Guardian/Caregiver First Name
Guardian/Caregiver Last Name
Guardian/Caregiver Email
Guardian/Caregiver Phone
Student Participation Information
This section must be filled out for each student participating in CHIRP.
Student First Name
Student Last Name
Student Birthdate (mm/dd/yyyy)
Student Age Group
5-8 years old
9-12 years old
Class Options
Choose between:
Full Fall Season
($50 discount for full season purchase)
Individual Series
(Click to view series and pricing)
September
- Energy & Physics
(9/11, 9/18, 9/25)
October
- Geography & Geology
(10/2, 10/16, 10/23, 10/30)
November
- Habitats & Ecosystem
s
(11/6, 11/13, 11/20, 11/27)
December
- Zoology & Population
(12/4, 12/11, 12/18)
Program Fee Subtotal
$
.00
Is the student receiving a
Charter School Purchase Order
?
Yes
No
Charter School Purchase Order
Families registering for CHIRP programming through purchase orders will incur a registration fee of $30 per student, per season.
Purchase orders cover the Program Fee which will not be charged to your card.
Charter School Name
Program Fee
$
.00
Registration Fee
$
.00
Friends of GRPC Membership Information
With the purchase of a GRPC
Sustaining Membership or Annual Membership
, a 25% discount will be applied to Monthly Series registration at checkout.
Do you have a Conservancy membership?
Yes
No
Discounted Program Fee
$
.00
Full Priced Program Fee
$
.00
Friends of GRPC Membership Information
With the purchase of a GRPC
Sustaining Membership or Annual Membership
, a 25% discount will be applied to Monthly Series registration at checkout.
Do you have a Conservancy membership?
Yes
No
Discounted Program Fee
$
.00
Full Priced Program Fee
$
.00
Total Due
Registration Fee
$
.00
SEASON Total
$
.00
SERIES Total
$
.00
Amount Due Today
$
.00
Payment Information
Name on Card
Card Number
MM
YY
Code
Billing Email
Registration Statement
Registration is not complete until payment is submitted, Family Information Form is filled out, and confirmation is received from GRPC.
You will be directed to the Family Information Form once this form is submitted.
I understand and agree to the Registration Statement.
Yes
Cancellation & Refund Policy
Please refer to our
Cancellation & Refund Policy
.
I understand and agree to the Cancellation & Refund Policy.
Yes
Contact Information