Coastal Explorers Registration Form |
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(once this form is received a welcome packet with health forms will be mailed home .) |
Note: Programs subject to minimum enrollment requirements. |
Please print and submit this form
with your check payable to:
Westport River Watershed Alliance (WRWA)
P.O. Box 3427,
Westport, MA 02790
Coastal Explorers Program : $160 per child WRWA members ($190*) *Non-member fee
| Please select program week desired: |
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Child #1 Name & Age: |
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Child #2 Name & Age: |
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Parent/Guardian Name: |
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| Mailing Address: |
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| Phone: |
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Charge your registration on Mastercard, Visa, AMEX, or Discover (please circle)
| Amount $ |
Exp. Date: |
| Card Number: |
last 3 digits (code on back) (4 digits on front of AMEX)
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| Billing address if different than above: |
*Pay the non-member rate for your child’s program fee, and we’ll apply the extra $30 towards your new membership. If you register a second child for the program, you pay the members-only rate.
The Westport River Watershed Alliance is a membership-supported, 501(c)(3) nonprofit organization.
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