spectrUM Spring 2022 After School Club Application

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The spectrUM Discovery Area has adopted an electronic form to collect parent/guardian responses for the health history, permissions, and application forms. This electronic form must be filled out, and staff will contact applicants soon to confirm registration.

Please complete this form for EACH CHILD you wish to enroll in the club.

If you have any questions or concerns you can reach out to Alyssa Giffin, spectrUM Camp Coordinator, at 406-544-9791.

First name of child *

Last name of child *

Child's birthday *

YYYY

First & last name of person completing this form *

Relation to Child *

Which days would you like to enroll your child? *

Tuesdays 3:30-5:30

Wednesdays 3:30-5:30

Both Tuesdays and Wednesdays 3:30-5:30

Required

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