Historical Museum of Southern Florida Graphic
 
Tropical Explorers Summer Camp Registration Form 2009

Pleace complete the form below and click the Submit button. If you are registering more than one child you will need to register each child separately.

If you have any questions please call 305-375-1492 or e-mail education@hmsf.org.
Student's Information
First Name
Last Name
Gender Male Female
Date of Birth
Age Ages 6-12
Home Phone Ex. 305-555-1234
Home Address 1
Home Address 2
City State Zip
Parent/Guardian’s Information
First Name
Last Name
Work Phone Ex. 305-555-1234
Cell Phone Ex. 305-555-1234
Home Phone Ex. 305-555-1234
Email
Same as Student Information above (This is for billing purposes.)
Address 1
Address 2
City State Zip
Country
Medical Information
List Any Medications
List Any Allergies
Special Needs
Emergency Contact
Phone
Physician’s Name
Phone
Please List Any Other Person(s) Authorized to Pick up Your Child (Separate names by commas)
Dates Information
  HMSF members Non-members   HMSF members Non-members   HMSF members Non-members

June 5
Historical Adventures
Single Day Camp

 $35 $40 June 8–June 13
Florida Fun Fest		 $165 $190

June 15–June 19
Splendid South America

 $165 $190
June 22 – June 26
Native American Traditions		 $165 $190 June 29 –July 3
Sea to Shining Sea		 $165 $190

July 6 – July 10
Magic City Memories

 $165 $190
July 13 – July 17
Mysteries of the Far East		 $165 $190 July 20 – July 24
People and Places in Africa		 $165 $190 July 27- July 31
Caribbean Mosaic		 $165 $190
August 3 – August 7
Across Europe and the Middle East		 $165 $190 August 10 – August 14
Marvelous Mexico		 $165 $190 August 17 – August 21
 Adventure Islands		 $165 $190
 
Total fee includes one T-shirt, snacks, and fieldtrips. Children must bring their own lunch.
 
I will not be registering a child but wish to make a contribution to the Historical Museum in the amount of $

If you prefer to mail this form to us please complete the registration form (please print) and send with full payment to:

Education Department,
Historical Museum of Southern Florida
101 West Flagler St.
Miami, FL 33130.

Confirmation letters will be mailed upon receipt of your registration form and full payment.

For additional registrations, please photocopy this form. For more information, call 305-375-1492.