Horizons Registration, Southeast Missouri State University


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Southeast Missouri State University

Horizons Registration

Note: After submitting your online registration form, call us at (573) 986-6879 with your credit card payment information or mail us a check to complete your registration. Registration is not complete until payment is received.

Registration Options
Register using the online registration form or you may print and mail or fax a registration form. Must be 18 years of age to register a Horizons participant.

Pre-registration
Pre-registration and pre-payment are required for all courses.

General Information
Read general information regarding Horizons programs online.

Please complete all fields of this form. (* Required Information)

Participant Information

First Name*

Middle Initial

Last Name*

Child's Birthday (i.e. 06/26/96)*

Gender

Male
Female

Street Address:*

City:*

State:*

ZIP:*

Day Telephone:*

Evening Telephone:

T-Shirt size:

Child Small
Child Medium
Child Large
Child X-Large
Child XX-Large

Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX - Large

Child's School:

How did you hear about Horizons?

Parent/Guardian Information

Parent/Guardian Name:*

Day Time Phone:*

E-mail Address:*

Emergency Contact Name:

Emergency Contact Number:

Class Information

Listed below are Horizons courses offered through the Office of Continuing Education. Online registration is available for all Continuing Education Horizons Courses.

Course Name:
Little Horizons (ages 5-8, unless otherwise specified)
Safari Adventures, Week One, A.M., $129 **FULL**
Good Guys vs. Bad Guys: An Adventure in Clay, Week One, P.M., $119
Superhero Science, Week Two, A.M. $119
Bajo el Mar – Under the Sea, Week Two, P.M. $119

Session One - June 27 - July 1, Mornings
Pottery Madness – A "Wheel" Adventure, $129 **FULL**
Robots Rock! Lego™ Robotics, $99 **FULL**
Southeast CSI, $119

Session One - June 27- July 1, Afternoons
Jr. Zookeeper $129
Steel Drum Band, $129

Session One - June 27 - July 1, All-Day
Don't Stop Believin' – A Singing Actor Camp, $149 **FULL**

Session Two - July 11-15, Mornings
Junior CEO, $129

Session Two - July 11-15, Afternoons
Get Animated! Intro to Computer Animation, $119
Junior Veterinarian, $129 **FULL**
Wilderness Survival for Kids, $109
Potion Power, $119
You Be the Judge, $119
Robots Rock! Lego™ Robotics, $99 **FULL**

Lunch Supervision/Pick-up
(Available only if enrolled in both an AM and PM session during the same week. Lunch will not be provided; child must bring his/her own sack lunch.)

Payment Method
Credit Card (you will be contacted by phone for your credit card information within 1-2 business days
but for faster service please call (573) 986-6879 with your information.)
Check (Submit this form and send payment to address below.)

Cancellation and Refund Policy:
Individual cancellations must be received in writing no later than June 7 to ensure a full refund of fees less a $10 administrative fee for each class. In the event that any course is cancelled, registrants will be notified and given the option of transferring to another available course or receiving a full refund.

Do you agree with this policy?
Yes, I have read and agree with the Cancellation and Refund Policy *
No, I do not agree with Policy

What is your gender? (Optional)
Male
Female

I understand that after submitting this form I will receive confirmation that my form has been received in the Office of Continuing Education and does not guarantee my enrollment. Upon payment, I understand that I will receive an official enrollment confirmation by mail from Continuing Education.

Mailing Address:
Southeast Missouri State University
Office of Continuing Education
One University Plaza, MS 6850
Cape Girardeau, Missouri 63701

Fax #: (573-986-6883) -- open 24 hours

If you have any problems completing the online registration form, please contact the Office of Continuing Education at (573) 986-6879 or e-mail coned@semo.edu.