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Future Lady Scientists

- Contact Us
  
  Sarah Wagner
  
  Director of Before/Aftercare, Afterschool Enrichment, and Summer Camp
  
  sarah.wagnerportlanddiocese.org
- Future Lady Scientists registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Select Number of Students
  11 remaining
  Please fill out this field.
  
  Student 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Student 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Student 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Student 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field.
  
  Food Allergies Please enter valid data.
  
  Parent Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent Email REQUIRED Please fill out this field. Please enter an email address.
  
  Parent Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Registered for regular full or part time aftercare? REQUIRED Yes No Please fill out this field.
  
  I understand, and agree, that if my child is not picked up from Future Lady Scientists Club at 4:15, she will be transferred to Aftercare, and additional Aftercare charges will be charged. REQUIRED Yes No Please fill out this field.
  
  Future Lady Scientists Club Fee REQUIRED
  40.0 – Regular Student Fee
  0.0 – Full/Part-time Aftercare Student Fee Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment