Discovery School Club UnPlugged Registration

Today's Date*
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Discovery School After School Adventures Session Registration: Club UnPlugged*
Mondays: 1st - 4th Graders (3:10-4:10 PM) Please check ALL Sessions that apply
- Select All
- Fall Session: Aug 29th - Nov 18th, 2022 Cost: $175
- Winter Session: Jan 9th - Mar 10th, 2023 Cost: $175
- Spring Session: Mar 20th - May 19th, 2023 Cost: $175
Are you a staff member at The Discovery School?
Please note that TDS Staff are given a 50% registration fee discount per child. This discount will be applied to your invoice and emailed to you.
How many members would you like to sign up for Club UnPlugged?*
Member's Name*
First Last
Member's Date of Birth*
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Member's Grade Level*
Member #2: Name*
First Last
Member #2: Date of Birth*
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Member's Grade Level*
Member #3: Name*
First Last
Member #3: Date of Birth*
MM slash DD slash YYYY
Member's Grade Level*
Member #4: Name*
First Last
Member #4: Date of Birth*
MM slash DD slash YYYY
Member's Grade Level*

Member's Legal Guardian*
First Last
Relationship to Member*
Please list your relationship to the Member(s) for whom you are filling out this registration form for.
Text Message and Email Communication Consent*
We will only communicate important program updates, registration, weather, and health information via email and text message. Your personal contact information will remain confidential and only used by Connections UnPlugged for the purpose of communicating program information.
I agree to receive text messages and email communication about program updates.
Contact Phone #*
Email*
Address*
Street Address Address Line 2 City State ZIP Code

Program Rates Consent*
Club Unplugged Program cost is $175 per Program Session, per participant. There is a 3% credit card processing fee added if payment by card is chosen at checkout. Make up dates will be provided if the school is closed due to holiday, weather, or health/safety closure.
Full program fees are due at the time of sign up. A program credit for a future session tuition can be granted if there are unfortunate circumstances communicated to a program leader. Refunds are handled on a case by case basis and subject to credit card processing fees.
By checking this box, I acknowledge that all sales are final.
Program Weather Policy*
Club Unplugged will run programming according to the scheduled dates. In the case of severe weather, we will follow school policy. If the school is closed due to weather conditions, we will not run programming that day. In the case of thunderstorms, class may be held indoors.
By checking this box, I acknowledge understanding the weather policy.
Media Consent*
Your child's safety and privacy is of utmost importance to us. Please check the following media consent that applies to your child. Clinical training includes use of images without names/location to teach UNF and JU interns. All images, video, and artwork will be the property of Connections UnPlugged Inc and used solely for parent update communication, clinical training, and Discovery School administrative purposes.
- I CONSENT AND ALLOW MY CHILD AND THEIR WORK TO BE PHOTOGRAPHED FOR CONFIDENTIAL PARENT EMAIL UPDATES ONLY.
- I CONSENT AND ALLOW MY CHILD AND THEIR WORK TO BE PHOTOGRAPHED FOR PARENT UPDATES AND DISCOVERY SCHOOL ADMINISTRATIVE PURPOSES ONLY.
- I CONSENT AND ALLOW MY CHILD AND THEIR WORK TO BE PHOTOGRAPHED FOR PARENT UPDATES, DISCOVERY SCHOOL ADMINISTRATIVE PURPOSES, AND CLINICAL TRAINING PURPOSES.

Discovery School

Club UnPlugged Registration

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