Science Saturdays Fall 2026

STUDENT DETAILS

DeleteStudent _ID_
First Name Preferred Name / Nickname (if any) Last Name HIDDEN: Email (pulls sys:relationship:email for receipt purposes) Birthdate Birthdate Grade Level Group Note: If the age group for your student is not displayed below, registration is at capacity for that group. Grade Level Group Note: If the age group for your student is not displayed below, registration is at capacity for that group. Saturday, October 24 at 09:00 AM - Fall: Grades 1-2Full Saturday, October 24 at 09:01 AM - Fall: Grades 3-4Full Saturday, October 24 at 09:02 AM - Fall: Grades 5-6Full Saturday, October 24 at 09:03 AM - Fall: Grades 7-8Full T-Shirt Size Does the participant have any needs or allergies we need to be aware of? Yes No Please explain:

Add Another Student

HOW DID YOU HEAR ABOUT SCIENCE SATURDAYS?

Which social media site / page?

Which school?

Which church?

PARENT INFORMATION

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to Child

Parent/Guardian Email

Parent/Guardian Phone

May Corban University text this number?

Yes

No

The parent information above is the emergency contact for the child while they are attending Science Saturdays.

Yes

No

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship to Child

Will anyone else besides the parent and/or emergency contact listed above be picking up your student(s)?

Yes

No

Authorized Pick-up Person Name

Authorized Pick-up Person Phone

Add another pick-up person

Authorized Pick-up Person Name

Authorized Pick-up Person Phone

Add another pick-up person

Authorized Pick-up Person Name

Authorized Pick-up Person Phone

RELEASE STATEMENTS

Media Release

I, the parent/guardian, of the above-named child, hereby authorize permission for my child’s name, image, and/or likeness to be photographed or filmed and used in Corban University videos, printed publications, websites, and social media.

Yes

No

I understand that photographs posted by fellow students, parents, or guardians are not the responsibility of Corban University.

Yes

Liability Release

As the parent/legal guardian of this participant of Science Saturdays, I acknowledge that there are certain dangers inherent in any activity and that bodily injury could occur while participating in Science Saturdays. I agree that the child listed above will hold Corban University, its staff, and representatives free from any and all liability for any and all accidents or injuries occurring to the participant as a result of participation in Science Saturdays, and hereby release Corban University, staff, and representatives from any and all such liability.

I agree

Parent Signature

Today's Date

PAYMENT

Scholarship Discount Code

Amount Due
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Amount Due

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