Registration Form

Please complete one registration form per child. ALL FIELDS ARE REQUIRED. All registrations wil be processed in the order they are received.

Space is now limited for the Amazing Animals camp, please call us at 508-929-2703 if you are interested in registering for this camp.

Thank you for submitting your summer camp registration form!

To help speed the processing of your registration, please include your child's name and birthdate in the Message to Seller box at the bottom of the Part 3 payment form. Thank you!

You may submit your payment in three ways:

Online Payment

Camper’s Name:
Birth Date (mm/dd/yyyy):
Age:
Parent/Guardian Name:
Address:
City: State: ZIP:
Phone (Work):
Please use the form xxx-xxx-xxxx
Phone (Home):
Please use the form xxx-xxx-xxxx
E-mail:
Where did you first hear about the camp? Family or Friends
While at the EcoTarium (ex. brochure, flyer, poster)
EcoTarium Website
EcoTarium Newsletter
Radio
Print Advertising
At a Camp or Resource Fair
Other
Membership Information:
If applicable. Membership (Family/Grandparent level or higher) must be valid during camp session to receive discount.		 Constituent #
Expiration Date
Membership Level
Cosmic Camp: One-Week Camp with Overnight
July 5 - 9 EcoTarium Members $270:
Non-Members $290:
Extended Hours 7:30am-9am: $45:
4-6:00pm: $60:
August 2 - 6 EcoTarium Members $270:
Non-Members $290:
Extended Hours 7:30-9am: $45:
4-6:00pm: $60:
How Things Work: One-Week Camp with Overnight
July 12 - 16 EcoTarium Members $270:
Non-Members $290:
Extended Hours 7:30-9am: $45:
4-6:00pm: $60:
August 9 - 13
 EcoTarium Members $270:
Non-Members $290:
Extended Hours 7:30-9am: $45:
4-6:00pm: $60:
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