Homeschool Science Classes

Homeschool Science Classes

Starting in 2018, Calusa Nature Center & Planetarium offers Life Science Homeschool Classes and, coming soon, Earth & Space Science Homeschool Classes. Click on the flyer below to see a larger version with details about the initial Life Science offering!




Register Below. These classes are limited to 20 students. First come, first served. (Please fill out a separate Registration for each child)
 

Student's First Name (required)

Student's Last Name (required)

Student's Birth Date YYYY-MM-DD (required)

Which days will your student be attending? (required field)(Click while holding down CTRL key to select more than one!) If you are paying for individual days, please specify which days in the text box below.

Please remember that your student's place will NOT be assured until you complete the payment (payment link, above this registration form, opens in new browser tab).


First Parent/Guardian's Name (required)

Phone Number where you can be reached in case of emergency (required)

Cell Phone (optional)

First Parent/Guardian's Full Address (required)
Street Address:
City:
State:
Zip:

Second Parent/Guardian's Name (optional)

Phone Number where you can be reached in case of emergency

Cell Phone

Second Parent/Guardian's Full Address
Street Address:
City:
State:
Zip:

EMERGENCY CONTACT INFORMATION (required)
Name (First, Last):
Relationship to Student:
Phone:

MEDICAL INFORMATION (required)
In order to provide the best possible handling of certain situations, please complete the following medical information: Does your student have any:
• Allergies (if yes, please describe; if none, enter None):

• Other mental or physical health condition that may affect your student’s participation in any part of the program? (This includes behavioral issues, so that we can determine appropriate staffing in advance. If yes, please describe; if none, enter None):


If your student will be dropped off and/or picked up by someone other than those listed above, please fill out the authorization for pickup:
I authorize my student to be picked up by the following person(s):
Name (First, Last):
Relationship to Student:
Cell Phone:
Name (First, Last):
Relationship to Student:
Cell Phone:


Additional Notes If you have any special questions or need to let us know something else, please type those here:


CONSENT (required for form submission)
I have read the description of the class(es) offered at Calusa Nature Center & Planetarium and understand that my student must arrive BEFORE 2 pm in order to be sure of a place in the class, regardless of payment status. I also understand that activities will be involved in my child's class science program; I find them acceptable for my child’s participation. Recognizing the educational benefits of this program to my child, and acknowledging that it is completely voluntary, I, the parent/guardian, do hereby agree to release, indemnify and hold harmless the Calusa Nature Center & Planetarium for any loss, injury or damage resulting directly or indirectly from my child's participation in this program. I also give permission for my child's picture to be included in Calusa update posts and/or class promotional images without name identification. My acceptance and submission of this form constitutes my digital signature (paper waiver will be signed on the first day of attendance).

Submitter's Name (one of the Parents/Guardians)(required)

Submitter's Email (required)

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