One moment please...
Arboretum Summer Club Registration Form
*
*
Mount Pisgah Arboretum Members get in for free to our walks, the Mushroom Festival and the Wildflower Festival. They also receive a Lane County Parking Pass, a discount on workshops and kids programs and reciprocal admission to many Botanical Gardens around the US. This program is $20 per session for Members, $30 per session Non-Members.
Membership Sign Up
*
Program Participant's Information
*

First Name
Last Name
*




*
*
*
If you're signing up more than one child, bring up information sections for each with this drop down.
Second Child
*

First Name
Last Name
*




*
*
*
Third Child
*

First Name
Last Name
*




*
*
*
Fourth Child
*

First Name
Last Name
*




*
*
*
Primary Parent/Guardian Contact Information

*

First Name
Last Name
*

*

*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Secondary Parent/Guardian's Information
*
*
We ask so you won't accidentally be linked as spouses/partners in our records if you aren't!


First Name
Last Name



First Name
Last Name


Other Important Adults

*

Mount Pisgah Arboretum Program Waiver

By signing below, I certify that I am the parent or legal guardian of the child listed above. In consideration of the right to participate in this activity, I release any and all claims for damages and losses suffered by me or my minor child/ward as a result of said participation against Mount Pisgah Arboretum and any officers or agents thereof. I further understand that there are certain risks inherent in this activity. I hereby agree to assume those risks on behalf of my minor child/ward and to hold harmless Mount Pisgah Arboretum and its agents. In the case of an injury or medical emergency, I give consent for Mount Pisgah Arboretum to provide or arrange for all necessary and appropriate medical/dental treatment as prescribed by qualified medical personnel. I have provided Mount Pisgah Arboretum with all relevant and necessary information about my child/ward’s medical and/or other special needs. I have read and understand the above.

*

*

(mm/dd/yyyy)
*