1-800-951-5750
 



Registration Details

*** Early sign-ups save 20% ***

Child/Children's
First/Last Names:
(please put multiple kids
on just one form)

Child/Children's Ages :

Parent(s) Names :

How Did you hear About us?

Home Number :

Cell Number :

Email Address :

Text Messages :

Which city do you live in?


LOCATION, DATES & TIME

 MENIFEE LOCATION: Callie Kirkpatrick Elementary School located at 28880 Reviere Dr, Menifee, 92584. The dates for this location are Tuesdays 10/1, 10/8, 10/15, and 10/22. MURRIETA LOCATION: E. Hale Curran Elementary School located at 40855 Chaco Canyon Rd., Murrieta, 92562. The dates for this location are Thursdays 10/3, 10/10, 10/17, and 10/24.


***All workshops will be held from 4:30-5:20 in the Multi-purpose room of the location you select***

PRICING

$79 for Registrations
in by Thursday, September 19th

Normally it's $95

This includes all four workshop dates for the location you select.

RELEASES

Liability Release: Release: The undersigned understands that participating in workshops with Reptiles for Students Workshop (and all its agents and employees) includes a risk of injury, including negligence on the part of Reptiles for Students Workshop agents and employees. The undersigned agrees to accept responsibility and discharges Reptiles for Students Workshop for any physical injury incurred during our workshops, regardless of the cause. The undersigned agrees to release Reptiles for Students Workshop and all its agents, employees, and affiliates from any claims or causes of action.

Parent or Guardian's Initials:
(Initials will represent digital signature)

Photo Release: Sometimes we like to take pictures of the kids in our workshops to add to our website, www.KidsReptileWorkshops.com. We do not list the child's name. Please sign below if you are comfortable with your child being a part of pictures at our workshops. "For good and valuable consideration, the receipt of which is hereby acknowledged, hereby irrevocably authorize Reptiles for Students Workshop to use photographs of me or my child(ren) and/or my property and authorize them and their assignees to use and publish the photographs herein described in any and all forms and media for the purpose of publicity, illustration, advertising, signs, websites or for any other lawful use as may be determined by Reptiles for Students Workshop and associates. I am of full legal age and hereby read and understand the terms of this release.

Parent or Guardian's Initials:
(Initials will represent digital signature)

Video Release : For good and valuable consideration, the receipt of which is hereby acknowledged, hereby irrevocably Reptiles for Students Workshop, to use video and audio footage of me, my child and/or my property and authorize them and their assignees and transferees to use and publish with or without my name and to use this footage for all forms and media for purposes of publicity, illustration, commercial art, advertising and publishing including CD’s, signs, brochures, fliers, websites, or for any other lawful use as may be determined by Reptiles for Students Workshop. I am of full and legal age and have read and understand the terms, or I am the parent of the child listed below and am signing for him or her as the legal guardian.


Parent or Guardian's Initials:
(Initials will represent digital signature)

Payment Processing

Name on Card:

Credit Card Number:

Expiration:

(Month/Year)

Total you authorize: $

Billing Zip Code:

Authorization:

I authorize this charge.