Date:   

Name(s) of Child(ren):   

Age(s):   

Parent's Name:   

Parents Cell Phone Number:   

Who will pick the child up:   

Emergency Contact Name:   

Emergency Contact Number:   

Number of Children Registering:   

Photo Release:
I authorize ScienceSouth and any media authorized by ScienceSouth to take and use without payment any photographs, audio and/or video of my child as needed for public relations, marketing, social media, advertising, or internal training purposes.

Over-time charge/Pick-up
Children should be picked up promptly at noon. Children left passed noon are subject to an overtime charge of $5/every five minutes late.