Hands-On Learning Services
Enter certificate number here
Fantastic Friday Science
Gift Certificate Redemption
Enter Friday Science dates child will be attending using this certificate
(list all that apply, separated by commas)
Parent Name (Last, First)
Parent email
Child Name (Last, First)
Child's grade
Child's school
Please list any health concerns or food allergies here (enter "N/A" if none)
Please list any special instructions here (enter "N/A" if none)
May we take photos of your child (photos may be used on website or FB)?
I, as parent/guardian of the above referenced child/children, give my permission for my child to participate in Fantastic Friday Science. I have read, understand, and will adhere to all policies oultined above, including but not limited to the medication policy.Further, I understand, agree to, and accept the policies of Hands-On Learning Services, with the understanding that neither the facilitators of this event nor AACPS, nor Eastport Elementary School are responsible for lost articles or injury.
Parent phone number(s)
Please indicate an emergency contact person and phone number
