Registration – St. Catherine of Siena Parish School

Bionerds Fall 2019 class at St. Catherine below has been CANCELLED. For questions, please email to admin@bionerdsllc.com. Thank you.

IMPORTANT MESSAGE:

Use the form below only for St. Catherine of Siena Parish School Classes. The registration is NOT for the public, only for students on site. For other facilities, please click here to go to the specific registration form. Please review our Class Schedules prior to registration.

Please review our policy documents below before you register. Don’t worry, our page is secure.

St. Catherine Winter 2019 Flyer

Child's Name:*

First

Last

Sex:*

Birthdate:*

day

month

year

School Name:*

Grade:*

Parent/Guardian's Name:*

First

Last

Relationship to child:*

E-mail:*

Address:*

Street AddressCityStatePostal / Zip Code

Phone:*

Area Code

Phone Number

Known Allergies:*

List known allergies:

Special health need(s)? (We do not administer medication to your child)*

Special health need or accommodation request? (We will try our best but not guaranteed)

Does your child go to school daycare before and/or after class?*

Emergency Contact:*

Emergency Contact Phone No:*

Area Code

Phone Number

Relationship to Child:*

Waiver form needs to be signed and submitted on the first day of class.*

I understand

I have read the Bionerds Sexual Abuse and Misconduct Prevention Policy and understood the content.*

Yes

I have read the Bionerds Laboratory Rules and Safety Guidelines and agreed to review it with my child.*

Yes

Join our mailing list?:*

How did you hear about us?*

We may send home a little "live friend" (such as cricket, ladybug, worms, etc. depending on the topics) with your child during the session. We want to make sure our little friend is welcome and taken care of. Are you okay with that?*

Select Session*

Total Price:

Security Code: