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					DEPARTMENT OF PARKS AND RECREATION, TOWNSHIP OF MOORESTOWN 2 Executive Drive, Suite 9A, Moorestown, New Jersey 08057 Phone: (856) 235-6344, FAX: (856) 914-3080,

WHO: WHEN: COST: Children ages 7-13 Tuesday, July 8, 2009 10:00 AM to 3:00 PM $ 25.00

TO REGISTER: Return signed permission slip and $ 25.00 during the summer registration period from May 11th through May 22nd between 8:30 AM and 4:30 PM, Monday through Friday. Due to limited space, reservations will be taken on a first come, first serve basis. The bus will leave from the Church Street Recreation Center Parking Lot at 9:30 AM. AM, and will return to the Church Street Center Lot at 3:00 PM. Children should bring a bagged lunch. All carry on lunch items should be clearly marked in a see-through bag with the child’s name. No glass permitted. --------------------------------------------Registration/Permission Slip--------------------------------------------ADVENTURE AQUARIUM - 2009 NAME __________________________________________________ AGE ___________________

ADDRESS ___________________________________________ PHONE _____________________ PARK SITE ________________________________________________ FEE __________________ I, as parent or guardian of ____________________, do hereby request the Department of Parks and Recreation, sponsors of the Aquarium Trip, to permit my child or ward to take part in all activities connected with the trip. I accept full responsibility for his/her doing so, thereby relieving the Dept. of Parks and Recreation and the Township of Moorestown from any possible liability. DATE ____________________ ______________________________________________ SIGNATURE OF PARENT/GUARDIAN

FOR DEPARTMENT USE ONLY Amount ________ Date ________ Cash _____ Ck _____ Ck# _____

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