Registering for Spacetime

To register your child for a SpaceTime event, please provide the following information:
Using our Upcoming Classes schedule can fill out much of this information for you!
If you have other questions, or want any other information, head to our Contact Us page

Fields marked with an asterisk (*) are required for registration.

Parent's Name(*):

Child's Name:

Child's Age:

Daytime Phone:

Email Address(*):

Address:

City/State/Zip:

What Class Would You Like to Register For?

If you are reserving a date for a party, please enter 'Party' and the date you'd like to schedule.

Class or School?(*):

Date? :

If you are registering for an Afterschool Enrichment program:

Homeroom Teacher:

Do they attend an aftercare program?

If you would like to provide information for an additional contact in the unlikely event of an emergency:

Name:

Phone:

Email:

Allergies?

Credit Card Information

If you do not wish to send your credit card number via the Internet, please be sure to provide a phone number so that we may contact you and either take that information over the phone or make other arrangments.

Credit Card #:

CVV #:

Expiration:

Zip:

/

(if different from address)

Other Notes:

Our group of homeschoolers LOVED the SpaceTime program, Rockin' Rockets! Ed kept the attention of a large group of kids for an hour with his fun and animated personality. And of course, the kids learned so much and want to all be astronauts now. I'm sure that we'll be doing another program with you all again. Thank you!
- Dana – Home School Coordinator