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Please use this form to register for activities and field trips
Please call us at 716-434-3196 if you have any questions. Thank you!
Pre-registration is required.
Fee payable at the door via cash or check.
*
Indicates required field
Participant's Name
*
First
Last
Age
*
2nd Participant's Name
*
First
Last
Age
*
Activity
*
Science Club
LEGO Robotics
C3 STEM Club
Space Mission
Field Trip
Camp
OTHER
Weekly programs:
Science Club (FREE): Thursdays @4:00-6:00pm
LEGO Robotics (FREE): Wednesdays @3:00-6:00pm
C3 STEM Club (FREE): Multiple locations
Phone Number
*
Email
*
School
*
Emergency Contact Name
*
First
Last
Contact's Phone Number
*
I here grant my child or children permission to attend CLC classes, field trips, and other off-site activities.
*
YES
NO
OTHER
Comments?
*
Photography Consent
I give the Challenger Learning Center of Lockport permission to use my child's name, likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of CLC of Lockport activities. I agree that CLC of Lockport has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the CLC of Lockport mission. These uses include, but are not limited to illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet.
Choose One
*
Yes, I give my permission.
No, I withhold permission.
Communications options
*
Please add me to your mailing list to receive updates.
I am already on the list. Thank you!
Please do not add me to your mailing list.
How did you hear about us? Choose all that apply.
*
Friend/Family
Facebook
Instagram
Twitter
Newspaper
Other
If other, please specify:
*
Send My Information
Calendar
About
Who We Are
Staff
Employment
>
Enrollment Agent
STEM Instructor
Board of Directors
Frequently Asked Questions
Gallery
Programs
Space Missions
>
Book a Mission
Virtual Missions
>
Sign up
Planetarium Shows
>
Book Planetarium
After School
>
Registration
Summer Camps
>
Summer camp registration
Birthday Parties
Scout Programs
Professional Development
Support Our Mission
Newsletter
Request a Quote
Membership
Volunteer
Donate
Press Room
Contact
STEM Resources