Welcome to BEan In Nature Wild Saturdays Spring 2020 Registration

Please complete one form per child for Program Registration.

If you have questions or concerns please contact marisa@beaninnature.com

www.beaninnature.com

As soon as you register we go to work preparing for your child administratively. We hold a space in the program and plan our teachers and supplies. For these reasons,

our Registration fee is a non-refundable for semester classes; $25 each child per semester

1 Session First time Trial registration; no REG

or

CATCH THE EARLY BIRD sessions; NO REG ALL SPRING!

Don't forget our Spring Campout!

Spring 2020

April 24-25th; Little Basin State Park

Need more info? Please see link and check box below for more info prior to register children!

2 parks!

with Kelsey!

2:00 pm to 5:00 pm

Saturdays- see dates and locations below*

Dates: Feb 1 and 15; March 14 MARCH 28; April 11

April 24 Family Camp out join us!

EARLY BIRD PRICES ALL SPRING!

5 sessions $263 NO REG

4 sessions $210 NO REG

3 sessions $165 NO REG

2 sessions $110 NO REG

1 Session (Trial NO REG $55)

AFTER EARLY BIRD PRICES ADD REG

5 sessions $263 ADD reg $25

4 sessions $210 ADD reg $25

3 sessions $165 ADD reg $25

2 sessions $110 ADD reg $25

1 session $55 (Trial any time drop in/no reg required)

*Dates and Locations

2/1~Morgan Hill

2/15~Stevens Creek

3/14~Morgan Hill

3/28~Stevens Creek

4/11~Morgan Hill

4/24-4/26~Family Spring Campout Little Basin

Select Program Below

Feb 1; Anderson Lake; Morgan Hill

Feb 15; Stevens Creek County Park; Cupertino

March 14; Anderson Lake; Morgan Hill

March 28; Stevens Creek County Park; Cupertino

April 11; Anderson Lake; Morgan Hill

Spring Campout April 24,25,26; please add us to distribution list; Cost is $80 per day per ea child participation; all ages family camp out-

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How did you hear about our programs? *

Full Name of Friend who referred you

Participant/Student Information

Participant First Name *

Last Name *

Birth Date * +

Female/male *

Age at start of program *

Household / Adult Primary Contact

Relationship to Participant: *

Mother

Father

Guardian

Other Other

Parent/Guardian Name *

Parent/Guardian Last Name *

Primary Phone Contact

Primary Phone *

Primary phone is *

Secondary Phone Contact

Secondary Phone *

Secondary phone is *

Email Address *

Address 1 *

Address 2

City *

Zip *

Emergency Contact #1

Emergency Contact First Name *

Last Name *

Phone Number *

Emergency Contact #2

Emergency Contact First Name *

Last Name *

Phone Number *

People authorized to pick up your child(ren)

Pick up person First Name

Last Name

Phone Number

First Name

Last Name

Phone Number