After School Program Registration

We're glad you've decided to join us for one of our events or programs!

Just fill in the details below and click the "print registration" button at the end. Please send in your printed registration form with your payment.

Send the printout in with your payment to: Marion Natural History Museum, PO Box 644, Marion MA 02738. Thank you!

Address*

Phone Number*
- Area Code Phone Number
Age
If you would like your child to be picked up from Sippican Elementary School for a Museum After School program, please complete the following section:
Sippican Pick Up

Yes, please pick up my child from Sippican Elementary.
I hereby give permission to Elizabeth Leidhold of the Marion Natural History Museum to pick up my son/daughter from Sippican School and walk them to the Marion Natural History Museum to attend the above program(s). I understand that pick up from the Museum is at 4:30pm unless otherwise noted in a program's description. My emergency contact information is the above number or will be provided in the space below.

By entering my name below I am signing this agreement and acknowledging the rules laid out above.
Your Name as Signature
Alternate Phone Number
- Area Code Phone Number
Select Program(s)*

~~Sippican Harbor Boat Trip, 5/16~~ Program Full! Looking at Watersheds, 6/6
Please total the number of programs you are registering for and indicate whether you are a museum member or non-member.
Number of Registrations*
Are You a Museum Member?*
PLEASE NOTE:

Your registration will not be secured until the Museum receives your payment. Please mail your payment to the Museum's PO Box (Box 644, Marion MA 02738) or drop off a check during the Museum's business hours. Registration fees are:
- $4 per child for Members
- $6 per child for non-Members
Print Registration Form
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