Brandywine Zoo - Spring Zoo Camp Registration Form

2008 Spring Zoo Camp Registration

Please complete the form and print it out. Then either fax it back to us with credit card information OR mail with check or credit card information.

Please make checks payable to Delaware Zoological Society.
A $15.00 fee for all cancellations up to February 28. ½ refund for cancellations after March 1. No refunds after March 15.

Fax Number: 302.571.7787

Brandywine Zoo
1001 North Park Drive
Wilmington, DE 19802

Name:

Sex:  M      F     Age:   (Proof of birth may be requested)

School:    Current Grade Level 2008:

Special Needs: (please explain)

Parent/Guardian Name:

Mailing Address:

City:  State:   Zip Code:

Home Phone:   Work Phone:
Cell Phone:  Parent/Guardian Email:

Emergency Contact:     Phone:

Please confirm my child for the program indicated below:

Spring Camp 2008 - March 24-March 28

Delaware Zoological Society Members (per child): $135/week or $30/day
Non-Members (per child): $170/week or $40/day.
Aftercare is available Monday-Thursday from 3:00pm-5:00pm.

Full Week      Monday, March 24     Tuesday, March 25
Wednesday, March 26  Thursday, March 27  Friday, March 28

Yes, please enroll my child in the Aftercare Program
$35.00/ Monday - Thursday    $10.00/day

Please supply dates needed for Aftercare

PAYMENT OPTIONS

Yes, I am a Family Member of the Delaware Zoological Society.

Enclosed is my check for reduced members ZooCamp fee of

Yes, I would like to become a Family Member of the Delaware Zoological Society.

My ZooCamp fee is enclosed along with Membership Fee. The total amount is

Enclosed is my Non-member Fee of

CREDIT CARD PAYMENT
Visa   Mastercard   American Express

Card #   Exp. date