Summer Nature Week – July 29-August 2, 2024

Please complete the required information below. The registration fee includes one adult and one child. Each additional child is $15. The name and age of EACH child that will be participating is required (separated by a comma in the space provided on the registration form).

Registration Info

Parent/Guardian First Name *

Parent/Guardian Last Name *

Email Address *

Street Address *

City *

State *

Postal Code *

Phone-Phone (Primary) *

Event Fee(s)

NON-MEMBER FEE (includes one adult, one child, materials)

$70.00

MEMBER FEE (includes one adult, one child, materials)

$50.00

EACH ADDITIONAL CHILD

$15.00

Total

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province

Postal Code

Child Information

Please enter your child's name and age in the areas below. If you have more than one child, please list each separated by a comma.

Child's Full Name *

Child's Age *

Previous Participation

Have you previously participated and if so, what year(s)?

Media Consent

I authorize Friends of Five Rivers, Inc., to use my photograph – with or without my name (only first name and last name initial if a minor) – for any lawful purpose, including organization-related printed and digital publications, on organization social media platforms (Facebook, Instagram, LinkedIn), and organization website all as needed to help promote and advertise the organization’s events and activities.

I understand and agree that these photos are or will become the property of Friends of Five Rivers, Inc. I also waive the right to approve the finished product where my likeness appears.

I understand this consent will remain in effect indefinitely until the images are no longer used by the Friends of Five Rivers, Inc., in electronic or printed formats for its communications or media relations activities.

I have read and understand the above.

Media Consent Permission *

YES NO

Paired with Another Family

Please list the name of the family you wish to be grouped with for the program.

Paired with Another Family