the central florida zoological park

 

Home School Classes at the Central Florida Zoo
Registration Form

Complete the following form and return it along with your payment. The cost is $12.00 per class for Zoo members and $15 for non-members. The cost per series is $40.00 for Zoo members and $50 for non-members. List the specific classes and dates on the form below. Class sizes are limited. Please observe age requirements. If registering for more than 5 classes, please submit form as many times as necessary.

*required field

Student Information
Student Name:
Birthdate:

Guardian Name:
Address:

City:
State:
Zip:
Phone:
E-mail*:
Allergies or limitations:
Class Title Date
1. (mm/dd/yy)
2. (mm/dd/yy)
3. (mm/dd/yy)
4. (mm/dd/yy)
5. (mm/dd/yy)
Payment Information
Amount enclosed:
Credit Card Type:
Credit Card#:
Exp. date: (mm/yy)
Customer ID#:
(last three digits on the back of the card)
Signature: