Mad Science After School Program Registration

Please Note

Classes will be scheduled AFTER registration closes based on enrollment numbers and teacher availability. We will email you with your student's specific class day and time within one week of registration closing.

School Information

Select School *

Parent/Guardian Information

Parent/Guardian Name *

Phone Number *

Email Address(es) * Separate multiple email addresses with commas (e.g., mom@email.com, dad@email.com)

Emergency Contact (Name & Phone) *

Students Information

Registering 1 student(s)

Payment Options

Program Cost

1 Student

Subtotal: $89.00

Tax (14%): $12.46

Total: $101.46

Credit Card
Pay securely online with any major credit card

E-Transfer (Recommended - Avoids Credit Card Fees!)
Send an e-transfer - saves you the 3.2% credit card processing fee

E-Transfer Instructions:
Send $101.46 to: admin@madsciencemaritimes.com
Please include your student's name in the message field
Autodeposit is enabled - no security question required

Mad Science Registration