Summer Discovery Days Registration Form
Send registration with payment to:
Roaring Brook Nature Center
70 Gracey Road, Canton, CT 06019
Child's Name:________________________________________Age:_____ Grade in Sept:____
|
| Address:_____________________________________________________________________ |
| Class Name:_________________________________________Dates:____________________ |
| Class Name:_________________________________________Dates:____________________ |
| Class Name:_________________________________________Dates:____________________ |
| Class Name:_________________________________________Dates:____________________ |
(indicate AM or PM if appropriate) |
| Parent's Name:________________________________________________________ |
| Parent's Signature:_____________________________________________________ |
| Parent Work/Day Phone: ___________________Home Phone:__________________ |
| Are you a member of Roaring Brook Nature Center/The Children's Museum? ____Yes ____No |