Summer Farm Camp 2017 Registration Form

The Learning Farm
11601 Gander St.
Anchorage, Alaska 99516

SUMMER FARM CAMP 2017

*** PRE-REGISTRATION & PREPAYMENT REQUIRED***
May 30 - August 18
Monday - Friday
(9am - 5pm)

Dates attending:______________________________________

Registration options:
____Morning: 9am-1pm  ($60)
____Afternoon: 1pm-5pm ($60)
____Full Day: 9am-5pm ($100)

DISCOUNT for enrolling 2 or more days:
 Half day rate: $50 Full day rate: $90

Name of Participant_____________________________

Age:__________

Address:______________________________________

_____________________________________________

Email:________________________________________

Parent/Guardian Name:________________________________

Best contact number:__________________________

Parent/Guardian Name:_________________________________

Best Contact number:___________________________

Emergency Contact: ___________________________________

Phone number:________________________________

*please make not of any allergies or other important information*

www.TheLearningFarm.net
Contact: Deborah Baines (907) 229-0359- Director
Email: info@thelearningfarm.net