Life Lab Events - Secure Registration Form

To pay by credit card, complete this form, print a copy for your records and click "Submit Form" button.
    You may also pay with a credit card by phone at 831-459-2001.
To pay by check or purchase order, print this form and send it with your payment to:
    Life Lab Science Program - Event Registration
    1156 High Street
    Santa Cruz, CA  95064
Confirmation and receipt will be sent by mail unless you specify otherwise in the comment section below.
? Questions ?   Please call us at 831-459-2001 or send email to Garden Director.
* Star fields are required.
Name:*
Your Child’s Name: ONLY if registering a child
Mailing Address:*
City:*     State:*     Zip:*
Phone:*
Email Address:*
Workshop/Event:

 

March 24, Discovering the Garden in Early Childhood Education,   $150 per person
March 29-30, The Growing Classroom,   $40 Refundable Deposit for Santa Cruz County Teachers and Garden Coordinators, $300 per person standard rate
April 21, MBSP Conference Rate,  Early Registration (before 3/30), $40
April 21, MBSP Conference Rate,  Regular/On-site (after 3/30), $50
April 21, MBSP Conference, Fulltime Student Rate (before 3/30), $25
April 21, MBSP Conference, 3 Teachers Same School (before 3/30), $100
April 21, MBSP Conference, additional Teachers Same School (before 3/30), $35 each
August 24, Discovering the Garden in Early Childhood Education,   $150 per person
September 27-28, The Growing Classroom,   $300 per person

Total number of people attending:*
Names of additional attendees:
Title/Grade Level Teaching: ONLY if attending workshop/conference
Payment: To pay by credit card enter card information or call with card number at (831) 459-2001. This secure form will be proccessed in our office and a confirmation & receipt will be sent to your address listed above. If you wish to pay by check or purchase order print this form and mail it to the address listed above.
Card Number: Expiration Date:
Billing Zip:
Comments:
  *** Please print a copy for your records. ***     ()