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 at least two weeks prior to your program date. The cost is $12.00 per class for Zoo members and $15 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: