Registration Form
For: Air Zoo Trip (5th - 8th Graders ONLY)
Date and Time: 8/22/2017 From 8:00:00 AM to 5:00:00 PM
Cost: $20.00

STUDENT INFORMATION PARENTAL INFORMATION
First Name* First Name*
Last Name* Last Name*
Address* Home Phone
City* Work Phone
Zipcode* Cell Phone
Email Address* Email Address*
School Would you like to attend Yes  No
Teacher Willing to drive Yes  No
Note: Drivers required to provide a copy of drivers license and proof of insurance.
Date of Birth   No. of available seat belts (including driver)
   

We often take pictures and/or video of the event for use by CRV ONLY. Do you approve of leting your student be photographed and/or video taped?
Yes     No