Online Registration Form for Design Your Dream Backyard Wildlife Habitat

Date:	Sunday, February 12
Time:	2:00 – 5:00 p.m.
Instructor:	Paula Campbell
Cost:	$40 for Arboretum members / $50 for non-members

Registrations will be processed for members first and then in order received.
Cancellation policy: You must notify us in writing via fax (713-682-2539) or email no later than 10 days prior to the class to receive a 50% refund.
Back to Design Your Dream Backyard Wldlife Habitat

Registration Information
* Your Name:
Second Participant Name:
*Address:
*City:
*State:
*Zip:
*Email:
*Home Phone:	(format: 111-222-3333)
Work Phone:
Cell Phone:
* Emergency Contact Name:
*Phone:
Are you an Arboretum member?:	Yes No Please add/renew my membership at the following level: Individual Membership - $35 Couple's Membership - $50 Family Membership - $70 Magnolia Level Membership - $150 Loblolly Level Membership - $500 Pecan Level Membership - $750 Founder's Circle Membership - $1,500
Are you a medical student?	Yes, Baylor College of Medicine (BCM) Yes, University of Texas, Health Science Center (UTHSC) No
How did you hear about this program?

Registration Amount
Total Number of Participants:	Cost per person: $40 for Arboretum members $50 for non-members
New/Renewing Membership Fee: (if applicable)	$
Discount or Coupon (if any):
Total Amount to be Charged:	$
Credit Card Information
*Card Type:	MasterCard Visa Discover AMEX
*Name on Card:
*Card Number:
*Expiration:	Month Year (format: 01)
Questions/Comments:
Please read:
By submitting this form, I certify that all the above participants are in good health and agree to indemnify the Houston Arboretum & Nature Center for all claims arising in connection with above programs without limit and regard to cause thereof or the sole, joint, or concurrent negligence of any parties including Houston Arboretum & Nature Center. I also agree that by submitting this form I also give permission for all the participants registered to be videotaped or photographed for use in Houston Arboretum & Nature Center publications, news publications or broadcasts or on the Houston Arboretum & Nature Center website. I also understand that: Registrations are processed for Arboretum members first, then in the order received. I am not registered for the class until receipt of confirmation via email. I must notify the Arboretum of cancellation, in writing, no later than 10 days prior to the class to receive a 50% refund. Class/Program Cancellation by the Arboretum Minimum Enrollment: The Arboretum reserves the right to cancel any program if minimum registration has not been met. A full refund will be issued for programs cancelled by the Arboretum for this reason. Inclement weather: Programs are held rain or shine; refunds will not be given due to weather unless class is cancelled by Arboretum. If severe weather is a possibility, the Arboretum will make every effort to contact participants regarding class cancellations or rescheduling. Please call our main line at 713-681-8433 or check our web site for updates. In severe weather, we will also announce class cancellations through 740 AM KTRH radio. Cancellation due to unforeseen circumstances: In the event a class or program must be cancelled due to unforeseen circumstances, the Arboretum will make every effort to notify participants as soon as possible and if the class will not be offered again, provide at the Arboretum’s discretion, a prorated credit or refund.