Earth Day Registration Form

    April 23, 2013
    Birmingham Zoo

    School & Lead Teacher Contact Information

    School

    System

    Lead Teacher (Main Contact)

    Phone Fax

    Email Address

    Classes Attending – Please give us the names of ALL teachers attending so we can sort goodie bags by class.

    Class 1

    Teacher#1 Grade

    Number of Students at $6 each :

    Number of Chaperones at $6 each:

    Class 1 Total Registration Fees:

    Class 2

    Teacher#2 Grade

    Number of Students at $6 each :

    Number of Chaperones at $6 each:

    Class 2 Total Registration Fees:

    Class 3

    Teacher#1 Grade

    Number of Students at $6 each :

    Number of Chaperones at $6 each:

    Class 3 Total Registration Fees:

    Registration Fee for ENTIRE school (sum of totals above):

    T-Shirt Orders

    Enter the quantity of t-shirts and corresponding totals for each size. $7 each and $10 for XXL and XXXL. T-shirts on Earth Day are $10 and $12
    Youth Medium Qty. Price
    Youth Large Qty. Price
    Adult Small Qty. Price
    Adult Medium Qty. Price
    Adult Large Qty. Price
    Adult XL Qty. Price
    Adult XXL Qty. Price
    Adult XXXL Qty. Price

    Total T-Shirt Order :