Museum Summer Camp Registration Form

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Contact Information

First Name: Last Name:

Email:

 

Please select which session(s) your child will attend:

Session 1: Adventures in Archaeology!, August 4-8, 9:00 a.m. – 4:00 p.m. (Ages 7-11)
Ever wonder what it’s like to be an Archaeologist? Find out what it takes to uncover the past through fun, hands-on activities. Dig for clues, piece together the past and learn what life was like for the first Oregonians.

Session 2: Go Deep! Explore Ancient Oregon, August 18-22, 9:00 a.m. – 4:00 p.m. (Ages 7-11)
What do giant sloths, volcanoes, tropical rainforests, sabertooth salmon and Tsunamis have in common? They are all part of Oregon’s history! Explore the wonders of Oregon by going deep in time through fun, hands-on activities. Investigate what fossils can teach us about the past and the future and discover what makes Oregon so unique.

 

Student Information

First Name: Last Name:

School: Grade as of Fall 2014: Date of Birth:

First Name: Last Name:

School: Grade as of Fall 2014:  Date of Birth:

First Name: Last Name:

School: Grade as of Fall 2014:  Date of Birth:

 

Parent/Guardian Information

First Name: Last Name:

Address: City:

State: Zip:

Home Phone: Work Phone: Cell Phone:

Relationship to Student:

 

First Name: Last Name:

Address: City:

State: Zip:

Home Phone: Work Phone: Cell Phone:

Relationship to Student:

 

Adult (other than those above) authorized to pick up child:

Phone: Cell:

Emergency Contact (other than those above):

Phone: Cell:

 

Special Needs

Medical Information (allergies, medications, diet restrictions):
This information is confidential and will not be shared with anyone other than your child's camp instructor.

Learning or behavior needs (learning disabilities, behavior issues that may affect group learning):
This information is critical in ensuring the very best experience for your child.

 

Payment Due
You may pay with a check by mail to the address listed below or pay by card in person or over the phone.

$245 General
$195 MNCH Member

Museum of Natural and Cultural History members receive discounts on programs throughout the year, including summer camp, after-school and weekend clubs as well as free admission to exhibits all year.

Family discount: 10% discount for two or more children 

Family discount: There is a 10% discount for two or more children attending the summer camp.

Cancellation Policy:
Up to 14 days prior to start of camp - 80% of fees will be refunded
Up to 5 days prior to start of camp - 50% of fees will be refunded
Cancellations made after the Thursday prior to the start of the session will not be refunded

Your registration is not finished until you complete the steps below:

In addition to filling out and submitting the form above, you will need to download, sign, and submit a Release of Liability and Emergency Medical Care and a Media Authorization and a Behavior Contract.

You may either mail or drop off the permission form with your payment to 1680 East 15th Ave., Eugene, OR 97403-1224.

Questions or payment by phone at (541) 346-1694 or in person, 9 a.m.-5 p.m. Monday through Friday