Registration Form

Students tide pooling in the San Juan Islands. Seastars: Pisaster Ocracheus, the Purple Seastar. 2 Students: Students collaborating at the tide pools . Forest Path: Old Growth Forest. Boy with Seastar: Student holding a Seastar. Rosario Beach

“Can’t wait for next year’s
outdoor ed!” .

Tara, student, Forest Park
Adventist School

Registration Form for Schools (go here for day camps)

Academic Adventures P.O. Box 1504 , LaConner, WA 98257 360-708-3286

Academic Adventures

Program Registration Form

2013

School/ Group Name:________________________________________

Group Coordinator Name:___________________________________

Phone: _________________Cell Phone:____________ Home Phone:_____________

Email:________________________________ Fax:_____________________________

Address:_________________________________________ ___Home ___School

City:____________________________ State:______ Zip:_________

Billing Information if different than above

Contact Name:__________________________________________________________

Address:_______________________________________________________________

City:______________ State:______ Zip:_________ Email:_____________________

Fax:_____________________ Phone:__________________

Program Fees: Program fees are per student and do not include food or lodging.

$200 Non-refundable Group Registration (Secures your groups dates)

Office Use: _______Received (Date:_________) Not Received:__________

Student Fees: $30/student/day Teachers and Chaperones: Free

Optional Adventure Activities: Added cost dependant upon Activity–consult with Director

Dates: (1st)____________________(2nd)_________________(3rd)__________________

Please provide date choices (see online Calendar)

www.AcademicsAndAdventures.org

Grade Levels/Group Type:________________________________________________

Number of Students:___________ Number of Program Days:__________________

Total number of Participants (approximate): ____students + ___Adults = ____Total

*1 Tuition Waiver provided / 15 students attending

Please tell us which curriculum areas you would like to have focused on during your program:_______________________________________________________________

_______________________________________________________________________

If your group is 15 or less would you be willing to combine with another group?_________________________________________________________________

Program Cost Worksheet:

Number of Students ________ X Number of Days _________X Program Fee______

Additional Activities? = Sub Total___________

Activity___________ Fee______ X Students_____ = Sub Total___________

Activity___________ Fee______ X Students_____ = Sub Total_________

Subtract Reg Fee if paid - $200

Tuition Waivers: 1 per 15 students Waivers ___ X Days _____X Fee___= - _________ Grand Total____________*

*Transportation, Food, Lodging not included.

$200 due at booking to secure date, balance due at date of service as a check to

Academic Adventures LLC

Thank – You!

I have read and understand the above registration. And understand the non-refundable $200 deposit.

Signature x______________________________________________ Date:___________

Return Registration form to:

Academic Adventures LLC

P.O. Box 1504

LaConner, WA 982257

Form may also be Emailed from our website Contact Area

www.AcademicsAndAdventures.org