NC Museum of Natural Sciences homepageProgram & Event Registration Form

Please print this form, fill it out, and mail along with your check to:

SCHEDULING COORDINATOR
NC Museum of Natural Sciences
11 West Jones St.
Raleigh, NC 27601-1029

A completed registration form and check for payment are necessary to register for activities that require a fee. Make checks payable to Museum Extension Fund. Information, consent, and health forms will be sent upon acceptance. The Museum can grant refunds only when a cancellation is received at least two weeks before the activity. A $20 processing fee is required for refunds, along with your Social Security number. Questions? Call 919.733.7450 x555.

Participant Name (18 or older):
Participant Name (18 or older):
Participant Name (18 or older):
Participant Name (18 or older):
Parent Name (for minors):
Child's Name: Grade/Age:
Child's Name: Grade/Age:
Address:
City: State: Zip:
Phone (home): Phone (work):
E-mail:
Membership #:                                  Exp. Date:    /    /
(For Friends - click here to join!)

Program # Program Title Session Date(s) Fee #Registering Total Fee
           
           
           
           
           
           
           
           
           
           
Total Amount Enclosed:  

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