Discovery Days Registration Form


Child's Name: ________________________________________	Grade in Sept:_________	Age _________

Class Name: _________________________________________	Dates: _______________	(Circle) AM or PM
Class Name: _________________________________________	Dates: _______________	AM or PM
Class Name: _________________________________________	Dates: _______________	AM or PM
Class Name: _________________________________________	Dates: _______________	AM or PM

Parent's Name (please print) :_________________________________________
Parent's Signature:___________________________________________________
Address:___________________________________________________________
Day Phone: ______________________Evening Phone:_____________________
Email:_____________________________________________________________
Are you a member of RBNC/The Childrens Museum? ____Yes ____No