OUTDOOR RANGERS
AND/OR
BE SMART WITH ART
2007 REGISTRATION FORM
Instructions
 1) Print this form. 2) Fill in information requested.
3) Sign the form. 4) Mail with your payment by check
Note: This form cannot be submitted online.

Please use one form per student enrolled.


Child's Name:_________________________________________

Date of Birth:______________________ M:_______ F:_________

Address:______________________________________________


City:__________________________ State:____ Zip:___________

Telephone: (day)_________________ (cell)___________________

Email: _________________________________________________

Medical Information/Allergies:_______________________________

**Special Needs:_________________________________________

Name of Parent or Guardian: _____________________________

Parent or Guardian Signature:_____________________________

Open to children ages 3 to 5. Classes are each 2 1/2 hours.

5-class sessions: $93.75 Flanders' members, $125 nonmembers

4-class sessions: $75 Flanders' members, $100 nonmembers

3-class sessions: $56.25 members / $75 nonmembers

2-class sessions: $37.50 Flanders' members, $50 nonmembers

Check program date(s) & circle AM or PM.

____ Outdoor Rangers: April Tuesdays - AM / PM (4 classes)
____ Be Smart with Art (April Wednesdays) - AM / PM (4 classes)
____ Be Smart with Art (April Thursdays) - AM / PM (3 classes)

____ Outdoor Rangers: MayTuesdays - AM / PM (4 classes)
____ Be Smart with Art (May Wednesdays) - AM / PM (4 classes)
____ Be Smart with Art (May Thursdays) - AM / PM (5 classes)

____ Outdoor Rangers: JuneMarch Tuesdays - AM / PM (2 classes)
____ Be Smart with Art (June Wednesdays) - AM / PM (2 classes)
____ Be Smart with Art (June Thursdays) - AM / PM (2 classes)


Circle one: Current Flanders Member / Nonmember

Optional Family Membership: $55/year _________

TOTAL ENCLOSED:________

Please mail this form (one per student) and payment by check to:
Flanders Nature Center & Land Trust
P.O. Box 702, Woodbury, CT 06798

Register in person at our office, located at the corner of Flanders & Church Hill Roads in Woodbury.

Space is limited. Registration and advance payment by mail or in person is required.