Register below for STEAMpark  Daily After School Enrichment Program at The Campus at Macedonia, 1924 Hecht Ave., Neptune, NJ:

Once Registration is complete, click here to make a payment or click her to pay by CashApp

Student's Name *
Student's Name
Birthdate *
Birthdate
Student's Address *
Student's Address
Parent/Guardian's Name *
Parent/Guardian's Name
Parent or Guardian's Phone Number *
Parent or Guardian's Phone Number
Please list any allergies or medical conditions we need to be aware of (enter N/A if not applicable)
Emergency Contact Name
Emergency Contact Name
Emergency Contact Primary Phone
Emergency Contact Primary Phone
Emergency Contact Alternate Phone
Emergency Contact Alternate Phone
Who else does student live with ? Please list everyone in the house including siblings
Who else does student live with ? Please list everyone in the house including siblings
Name
Name
I give permission for my child to be photographed and recorded by staff members participating in the program. I verify that I know media may be used at the discretion of STEAMpark, INC for creating photo memories for my child and me, enhancing the learning experience, sharing successes with the community, and promoting the program in general. Funding for the STEAMpark Academy After-School program requires that statistical information for participating students is collected and reported. In addition, each student is supported based on his or her academic level and needs so that individual performance goals can be met in accordance with and support of the student’s sending school and district. Evaluators keep all information strictly confidential. With my signature on this form, I acknowledge and give my consent.
Parent/Guardian Name
Parent/Guardian Name
Date
Date

Your registration is not complete until you hit "submit."

After completing registration, click here to make a payment.