Education: Nature & Zoo Tots Registration Form

Registration - Nature & Zoo Tots

Registration is NOT complete until payment is received. Please call 204-927-6070 to submit payment with Visa or MasterCard by phone. Alternatively, please send a cheque addressed to 'Assiniboine Park Conservancy' to 55 Pavilion Crescent, Winnipeg, MB R3P 2N6.
Nature & Zoo Tots are for children aged 3 to 5 with an adult partner.

* Required
Tot's Name*

First NameLast Name
Birthdate*

MonthDayYear
Allergies

Insect BitesNuts/PeanutsPollen/grassesWheat/GlutenMilkOther
Purchaser's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Assiniboine Park & Zoo Membership Number
Assiniboine Park & Zoo Members receive a 10% discount on Workshop fees*
I would like to register for the following Nature and/or Zoo Tots:
Program Name:*
Program Date(s):*
Program Time(s):*
Price + 5% GST*
Assiniboine Park & Zoo Members receive a 10% discount on Workshop fees*
Program Name:
Program Date(s):
Program Time(s):
Price + 5% GST
Assiniboine Park & Zoo Members receive a 10% discount on Workshop fees*
Fees
- Prices vary depending on the course - please see our website for details
- Please include 5% GST
- No refunds unless workshop is cancelled by Assinsiboine Park Conservancy
* Membership must be valid at the time of purchase. Membership discount does not apply to programs run by independent third parties. (ex. Fit 4 Two)
Total Amount Owing (including 5% GST)*
Payment*

Cheque (payable to Assiniboine Park Conservancy)I will call 204-927-6070 with Visa or Mastercard number
Questions or Comments
Would you like to receive e-mails from Assiniboine Park Conservancy including information about events, programming, and education offered at Assiniboine Park & Zoo?

YesNo
Should be Empty:

Registration - Nature & Zoo Tots