Registration
StreetAddress:
7115 Main Street, Rte 25
Trumbull, CT  06611
Phone: (203) 452-4421
info@patronsoftnac.com

Mailing Address: 
Patrons of TNAC, Inc.
P.O. Box 110438
Trumbull, CT  06611

Name:

Address:

Home Phone:

Alt. Phone:

Email:
Membership:
Class Name:

Attendee:

Names/DOB:

Allergies/Medical
Conditions:

Emergency
Contact Name:

Phone Number:
I certify that my child/children is/are healthy and free of problems that could hinder his/her participation in Trumbull Nature and Art Center Classes.

In case of injury, I wish to be contacted as soon as possible at the telephone listed above. If I cannot be reached, please contact individual listed as emergency contact above at the telephone number provided. In the event of serious illness or injury which would require my child to be sent to a local hospital via ambulance, I understand that I am responsible for all charges either through health insurance or otherwise.

Please note that if your child is assisted during the school year, we encourage you to accompany him/her during the program. Thank you for your consideration.

Cancellation Policy: The Trumbull Nature & Arts Center’s cancellation policy states that reimbursement in full will be given only to classes that are cancelled by the Nature Center.
Make checks payable to: Patrons of TNAC, Inc.  
Mail to: P.O. Box 110438, Trumbull, CT  06611
Questions on Registration? Contact - registrar@patronsoftnac.com
I acknowledge that I have read the above statements and attest and agree to them.