File - Capron Park Zoo

Capron Park Zoo ‘Exciting an interest in the natural world through conservation, education, and recreation’ 201 County St. Attleboro, MA 02703 www.capronparkzoo.com Phone (774) 203­1840 Fax (508) 223­2208 PLEASE PRINT CLEARLY Membership Form Name: _______________________________________________ Individual Member $25 A member pass, good for one year Discounted/free admission to over 100 institutions nationwide A Member’s Newsletter Name: _______________________________________________ Senior Household* $45 § An annual member pass for 2 senior adults who live at the address listed on the membership card and four grandchildren under 18; § Discounted/free admission to over 100 institutions nationwide; § Discounts on educational programming; § A Member’s Newsletter. Address: _____________________________________________ § § § Household** $55 § A annual member pass for 2 adults who live at the address listed on the membership card and four children under 18; § Discounted/free admission to over 100 institution nationwide; § Discounts on educational programming; § A Member’s Newsletter. Household Plus** $65 § A annual member pass for 2 adults who live at the address listed on the membership card and four children under 18 PLUS the adult caregiver*** listed on the membership card; § Discounted/free admission to over 100 institution nationwide; § Discounts on educational programming; § A Member’s Newsletter. Caregiver (Household Plus ONLY): ________________________ _____________________________________________________ City: ____________________ State: _________ ZIP:__________ Phone* : ______________________________ Email*: _______________________________________________ Cards will only be issued to adults over the age of 18 * Capron Park Zoo will not give your information to any other organization Membership Level Please Circle Level Fee Individual $25 Supporting $100 § Benefits of Household Membership PLUS two additional guests Senior Household $45 Household $55 Household Plus $65 Sustaining $200 § Benefits of Household Membership PLUS four additional guests Supporting $100 Sustaining $200 Patron $500 Patron $500 § Benefits of Household Membership PLUS all additional guests Payment Type: ____ Cash or Money Order * A Senior Household is defined as the two senior adults who permanently reside at the same address and are at least 55 years of age. The names of senior adults will be listed on the card. Proof of age is required to qualify for this level of membership. ** A Household is defined as the two adults who permanently reside at the same address and up to four children. The names of adults will be listed on the membership card. If your household includes more than 4 children, contact the Membership Department. ____ Check­please include a phone number on your check ____ Credit Card (Mastercard or Visa accepted­sorry we do not accept AMEX or Discover) Card # ___________________________________________ Exp: _________________ Signature: ________________________________________
*** A Caregiver is defined as a person who regularly provides child care to your household. Caregivers MUST be listed on the membership card in order to use the membership! If you change caregivers, it is your responsibility to contact the Membership Department to update the information. Send this form and your payment to: Free admission to the zoo DOES NOT include special evening events such as Zoo Boo or Zoo Moon Capron Park Zoo Membership Office 201 County St Attleboro, MA 02703