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After-School Program Request Form

Please use this form to indicate your program preferences. Once we receive your request, we will contact you to confirm.

If you have any questions please contact Mad Science for more information at or call (714) 668-9174.

Thank you and have a Beautiful Beaker-rific! DAY!

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Customer Information
Contact InformationIt is important that we are able to contact you if we have any questions. Please provide a phone number where you can be reached. Your email address will be used to send you information relating to your afterschool program set up.
After School Program Information:If you have questions about these details we can discuss them as we set up your program.
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