Explorer for a Day

Student Information

Student First Name*

Student Last Name*

Student Date of Birth*

Student Email Address*

Parent/Guardian Email Address

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to Student

Event Information

Number of Guests*

Do you or any of your guests have any dietary restrictions?

Please explain:

Do you or any of your guests need any accommodations?

Please explain:

What is the primary language spoken by your guests?