Earth Day Registration Form

April 23, 2013
Birmingham Zoo

School & Lead Teacher Contact Information

School

System

Lead Teacher (Main Contact)

Phone Fax

Email Address

Classes Attending – Please give us the names of ALL teachers attending so we can sort goodie bags by class.

Class 1

Teacher#1 Grade

Number of Students at $6 each :

Number of Chaperones at $6 each:

Class 1 Total Registration Fees:

Class 2

Teacher#2 Grade

Number of Students at $6 each :

Number of Chaperones at $6 each:

Class 2 Total Registration Fees:

Class 3

Teacher#1 Grade

Number of Students at $6 each :

Number of Chaperones at $6 each:

Class 3 Total Registration Fees:

Registration Fee for ENTIRE school (sum of totals above):

T-Shirt Orders

Enter the quantity of t-shirts and corresponding totals for each size. $7 each and $10 for XXL and XXXL. T-shirts on Earth Day are $10 and $12
Youth Medium Qty. Price
Youth Large Qty. Price
Adult Small Qty. Price
Adult Medium Qty. Price
Adult Large Qty. Price
Adult XL Qty. Price
Adult XXL Qty. Price
Adult XXXL Qty. Price

Total T-Shirt Order :