Discovery Days Registration Form

Send registration with payment to:

Roaring Brook Nature Center
70 Gracey Road, Canton, CT 06019

Child's Name
Age
Class
Dates
Cost
1.
2.
3.
4.
 
Parent's Name:________________________________________________________________  
Address:______________________________________________________________________
Day Phone: ________________________Evening Phone:______________________________
Are you a member of Roaring Brook Nature Center/Science Center of CT? ____Yes ____No

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