Program & 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: |
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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 |
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