Homeschool: MONdays january 5 – June 8, 2026, 9am-3pm Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Your Name *FirstLastChild's Name *FirstLastEmail *Phone Number *Does your child have any allergies or dietary needs? *YesNoIf yes, please describeChild's AgeAdditional Guardian's Name (optional)FirstLastAdditional Phone NumberAdditional EmailDo you need to drop off/pick up at times other than 9am and 3pm?Do you need help with transportation? Pick up, drop off, or certain dates?Any other notes/preferences you'd like to addIs it alright if we use pictures taken during programming on the website and social media?YesNoAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePlease review: Waiver and Permision to Transport Child/Children Sprouts Cancellation Policy Transportation Waiver *I give permission to transport my child/childrenI'd prefer to find an alternate solutionI agree to the Cancellation Policy *YesNoType your full name as an electronic signature *Payment Options *Pay full amount now50% deposit now and 50% at the start of programmingReserving Your SpotPrice: $1,368.00 $72 per week 19 weeks, Jan 5-June 8, 9am-3pm Payment can be made through Venmo to @sproutsnatureschool, Zelle to 608-320-9279, Cash App to $sproutsnatureschool, check or cash. I also have Apple Pay. If you have any questions let me know. Credit card is less preferred, option is below:Credit CardSubmit
