Registration Form

To register for an event, select the appropriate registration fee from the drop down list for the desired event(s) and then click on the "Register" button at the bottom of the page.

Category:
Title Subtitle Dates  
Playful Escapes Native America All Day Nov. 27, 2009
Playful Escapes Native America Half Day Nov. 27, 2009
Playful Escapes Birds of Florida All Day Dec. 28, 2009
Playful Escapes Birds of Florida Half Day Dec. 28, 2009
Playful Escapes Paleontology All Day Dec. 29, 2009
Playful Escapes Paleontology Half Day Dec. 29, 2009
Playful Escapes Mad Scientist All Day Dec. 30, 2009
Playful Escapes Mad Scientist Half Day Dec. 30, 2009
Overnight At The Museum Adult/Child Pair Feb. 27, 2010
Overnight At The Museum Addtional Person Feb. 27, 2010
Overnight At The Museum Addtional Person Feb. 27, 2010
Museum Membership
Are you a member? Member #:
For Children's Classes Only
Student's Name:
first
last
Parent/Gaurdian's Name: (if student is under 18)
Child's Grade:
Child Pick Up:
Please list the names of the people authorized to pick up your child from the museum.
Emergency Information
Emergency Contact Name:
Emergency Contact Phone:
Family Physician Name:
Family Physician Phone:
Medical Information:
Please list any pertinent medical conditions, allergies, medications, or other health related details.
Permission Release Statement

I have read the description of the camp(s) and find them acceptable to my child's participation. In addition, my child has permission to participate in the field trips. Recognizing the educational benefits of this program to my child and acknowledging that it is completely voluntary, I his/her parent/guardian, do hereby covenant with the University of Florida that I will never sue or bring any legal action or proceedings against the Florida Board of Education, the Florida Museum of Natural History, the University of Florida, or their agents or employees, the owner(s) of any real property visited and the drivers of the transporting vehicles for any amount in excess of their automobile insurance coverage for or on account of any injury or damage sustained by virtue of or arising out of the field trips. I would be protected through the driver's regular medical and liability coverage to its limitations only.

I authorize the Florida Museum of Natural History to arrange any necessary emergency treatment in the event that I cannot be reached.

I authorize the Florida Museum of Natural History to photograph and videotape my child and to utilize these images for promotional purposes.

Disclaimer: The Florida Museum of Natural History does not consider itself to be nor hold itself out as a dependent care center for the purposes of the Internal Revenue Code.