Student Registration Form

Student Information

Student's Name:
* First Name:
* Last Name:
Parent/Guardian's Name:
* First Name:
* Last Name:
Line 1:

Line 2:

Postal Code:
Date of Birth:
School Name:
Grade Level in Science:

Contact Information

* Home Phone:
* Email:

Additional Information

Please let us know what the child and you as a parent are expecting of this program:

Emergency Contacts

Contact's Name:
First Name:
Last Name:
Emergency Contact Phone:
Student's Health Card No:

Course Information

Course Selection:
Light - Junior LevelLight - Intermediate LevelLight - Advanced LevelElectricity & Magnetism - Junior LevelElectricity & Magnetism - Intermediate LevelElectricity & Magnetism - Advanced LevelMechanics - Junior LevelMechanics - Intermediate LevelMechanics - Advanced LevelNewton's Laws - Junior LevelNewton's Laws - Intermediate LevelNewton's Laws - Advanced Level

Note: Edge of Science aims at imparting hands on exposure to students. A child will perform experiments under the supervision of experienced teaching staff . Each session will start with a ten minutes introduction and demonstration by the staff followed by hands on by the students. Topics covered under each level will depend upon the teaching staff based on the skills and aptitude of the children. Fees should be paid in full at the time of registration. Students are encouraged to come five to ten minutes earlier to their class in order to settle down before the teacher begins their demonstration. Please issue check payable to "EDGE of SCIENCE Inc."

* Acknowledgement:
I acknowledge that I have read and understood the terms and conditions provided in this registration form. The information provided in this form for my child/ward is true and I agree to follow the conditions laid out by the institution.
* Signature: