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Lagoon Academy

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Lagoon Academy THURSDAY - March 2021

Lagoon Academy THURSDAY - March 2021

Lagoon Academy

$54.00 - $60.00

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Lagoon Academy TUESDAYs - March 2021

Lagoon Academy TUESDAYs - March 2021

Lagoon Academy

$54.00 - $60.00

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Lagoon Academy THURSDAY - March 2021

This month Lagoon Academy students will study fish biology!

1 Month Non-member - $60.00 1 Month ELC Member - $54.00

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Student Name (first and last)*

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Student Date of Birth*

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List Your Child's Medical Conditions or Allergies (If none, please type N/A)*

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Parent First Name*

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Parent Last Name*

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Street Address*

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City*

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State*

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Zipcode*

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E-mail Address*

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Primary Phone Number*

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Alternate Phone Number*

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Emergency Contact Name*

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Emergency Contacts Relationship to Student*

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Emergency Contacts Primary Phone Number*

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Emergency Contacts Alternate Phone Number*

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All Adults Authorized to Pick Up Student (First and Last name of each; separate each with a comma)*

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Click Here For Behavior Policy

I've read the Behavioral Policy and I agree to the rules and procedures*

Click Here for Indemnification & Hold Harmless Statement

I've read the indemnification and hold harmless statement and I agree to the terms and conditions*

I acknowledge that refunds will only be granted up to 3 weeks prior to start of session, and that no refunds will be issued after that time.*

How did you hear about ELC's Lagoon Academy?*

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Lagoon Academy TUESDAYs - March 2021

This month Lagoon Academy students will study fish biology!

1 Month Non-member - $60.00 1 Month ELC Member - $54.00

Payment Day:

Payment Day:

Make my first payment today

Student Name (first and last)*

This field is required.

Student Date of Birth*

This field is required.

List Your Child's Medical Conditions or Allergies (If none, please type N/A)*

This field is required.

Parent First Name*

This field is required.

Parent Last Name*

This field is required.

Street Address*

This field is required.

City*

This field is required.

State*

This field is required.

Zipcode*

This field is required.

E-mail Address*

This field is required.

Primary Phone Number*

This field is required.

Alternate Phone Number*

This field is required.

Emergency Contact Name*

This field is required.

Emergency Contacts Relationship to Student*

This field is required.

Emergency Contacts Primary Phone Number*

This field is required.

Emergency Contacts Alternate Phone Number*

This field is required.

All Adults Authorized to Pick Up Student (First and Last name of each; separate each with a comma)*

This field is required.

Click Here For Behavior Policy

I've read the Behavioral Policy and I agree to the rules and procedures*

Click Here for Indemnification & Hold Harmless Statement

I've read the indemnification and hold harmless statement and I agree to the terms and conditions*

I acknowledge that refunds will only be granted up to 3 weeks prior to start of session, and that no refunds will be issued after that time.*

How did you hear about ELC's Lagoon Academy?*

This field is required.

Any Additional Notes or Comments

This field is required.

Keep Browsing

Payment

255 Live Oak Drive, Vero Beach, Florida 32963

T: 772-589-5050
F: 772-589-7723
E: info@DiscoverELC.org

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