Mother, Grandmother & Daughter Engineering Event Registration Form.

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An opportunity for girls in the 2nd to 7th grade to spend the morning with their mom, grandmother or mentor to tackle science and engineering design challenges!
Space is limited, so please make sure you are able to attend. The Event is from on June 4th from 10:00am to 12:00pm at The Carver on 7 Academy Street, Norwalk.

Email *

Is your child currently enrolled in The Carver After School Program at your school *

Yes

No, skip the next question

If yes, which program? *

After The Bell AM/PM

After The Bell AM only

After The Bell PM only

5th Grade Scholar Program

After School Program in the Middle Schools

Other:

Child's Name *

Child's Birth Day *

Child's Age *

Child's School *

Grade Attending *

Parent's Name *

Address with City, State and Zip *

Cell Number *

Emergency Contact and cell number *

Voice, Likeness & Comments Release: I give permission to The Carver and Saturday Academy Inc. to use photographic images taken or likeness of my child in college publications, displays, marketing materials and website pages. I understand my child's imagine may also be used in press releases and sent to news publications and other forms of print and digital media. I fully understand the intent of using my child's likeness and /or comments, and doing so do hereby relinquish any responsibility on the part of The Carver and Saturday Academy Inc. *

Yes, I give permission

No, I do not give permission

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