Class Registration

All classes are full at this time. Please check back soon for new registration opportunities.

Before submitting your class registration, please review the Class Policies and Terms.

After submitting your registration form, please visit Checkout to submit your payment. Your child will be enrolled in the class when the registration form and payment are both submitted. You will receive a confirmation email of your enrollment status.

If you are enrolling more than one child, please submit a separate form for each child. If you wish to request a sibling discount, please send an email to lori@curiosityzoneclermont.com to request an invoice for your payment amount.

Primary Parent or Guardian First Name and Last Name (required)

Your Email (required)

Class (required)

Your child's First Name and Last Name (required)

Your child's grade (required)

Your child's birthday (required)

Home Address (required)

Primary Parent or Guardian Phone Number (required)

Alternative Phone Number for Parent (optional)

Emergency Contact Name and Relation (required)

Emergency Contact Phone Number (required)

Does your child any allergies, medical, personal, or special needs that we need be aware of? (required)
YesNo

If answered yes to the prior question, please describe precautions and emergency procedures:

Class Policies and Terms: Do you agree to the class policies, terms, and payment schedule? (required)
YesNo

Payment Schedule via PayPal (required)
Pay in FullPay in Installments

Parent Signature (required): My electronic signature confirms that the above information is accurate; that the guidelines and procedures of the program my child is registered for will be adhered to; and that I understand it is my responsibility to keep the above information current. Furthermore, I have discussed the behavior expectations with my child.

If your device does not display the reCaptcha security feature above the send button, please submit your form on a different device.

Once you hit the black send button, the box should change color and note that the message was sent successfully.