ROSE CREEK FARMS
Beneficial Insect Day - Lady
Bug Mania
Registration Form
HOW
TO JOIN… Please print and
fill-out this form and return with your payment. Do not edit this class
registration form. Please retain a copy for your records.
Please note that
there is limited attendance on each of these days. Please register early to
secure your entry.
Class you want to
participate in: Lady Bug Mania
Date of scheduled
class: April 18TH
2012 3rd and 4th
graders or April 20th, 2012
5th and 6th graders (please circle which one your
class will be attending)
NAME OF SCHOOL OR
AFFILIATION: ________________________________________________________________
NAME OF CONTACT
PERSON: ______________________________________________________________________
ADDRESS:
___________________________________________________________________
CITY:
______________________________________________
ZIP:
______________________________
NUMBER OF CHILDREN TO
ATTEND: ______________________
NUMBER OF PARENTS OR
CHAPERONES TO ATTEND: _______________________________ (Note: MUST have
at least one adult chaperone to 6 children)
NUMBER OF ATTENDIES
_______ X $7.00 per child = $________________ (Note: Fees must be included with Registration form)
NUMBER OF CHAPERONES:
_________ (Free)
NUMBER OF SCHOLORSHIPS
NEEDED: __________________ (Note: please call Pam in advance for scholarships
they are limited 940-427-2609)
PHONE:
____________________________________________
CELL PHONE OF CONTACT
PERSON: _______________________________________
EMAIL ***required to
receive fee confirmation and information about class***
Email: ________________________________________________________________
Mail registration form and check to: Rose Creek Farms - 418 County Road 2788, Sunset, Texas 76270. Registration form and fee to be received at least 2 weeks prior to Lady Bug Mania event day. Please note: If you cancel less than 5 days before the date of a class or fail to show up on the day of the class, no refund will be given. Classes are limited. Guest speaker may attend.
Please note: Please let the parents know there will be souvenirs for purchase the day of the event.