RWP Zoo : Education Program Registration Form

Adult's Name:
Address:
City:	State: Zip:
Phone:	Email:
Zoo member?: Yes No
Membership Number:
Membership Expiration Date:

Credit Card Information
Card Number:
Type: Expiration:
Signature: _______________________________________

Please fill out this form completely. Insert participant’s name, age, program codes for each desired program and the fee (see fee chart on right). Space is limited—2nd and 3rd choices are recommended.

Questions? Call Gerry at (401) 785-3510 x358 or Donna at x351.

If you are paying by credit card

Print out the completed form below with Credit Card
information and fax to (401) 941-3988 or mail to
RWPZ/RIZS 1000 Elmwood Ave. Prov, RI 02907

If you are paying by check

Print out the completed form below

Make check payable to Rhode Island Zoological Society

Mail the completed form along with payment to
RWPZ/RIZS 1000 Elmwood Ave. Prov, RI 02907

Questions? Call (401) 941-3910

PROGRAM FEE CHART

Preschool Fees

Members: $14 per child
Non-Members: $20 per child

Zoo Explorers

Members: $14 per child
Non-Members: $20 per child

Wild Tales Fees

Members: $14 per child
Non-Members: $20 per child

Roots & Shoots
Club dues are $75 for Oct. - June

Bug Club
Club dues are $45 per session

KidzArt
Members Fees: $20 per session
Non-members: $30 per session


Participant Name	Date of Birth	1st Choice	2nd Choice	3rd Choice	$
Example: Sally	01/01/04	PM10A	PM12B	PM17A	$ 14














FEE GRAND TOTAL:


	Roger Williams Park Zoo 1000 Elmwood Avenue . Providence, RI 02907 . 401-785-3510 © 2000 - 2009 Roger Willliams Park Zoo and RI Zoological Society.			All Rights Reserved. Privacy Policy/Terms of Use Contact Us