Belt Loop Day Registration Form

5/27/2013 1:00 PM	Memorial Day- Museum Closed
5/31/2013 6:00 PM	Members-Only Exhibit Preview: "Diamonds"
6/1/2013 10:00 AM	New Exhibit Opening: "Diamonds"
6/12/2013 6:00 PM	Members-Only Summer Movie Series: "Big Miracle"
6/16/2013 10:00 AM	Happy Father's Day: Free Museum admission for Dads
7/10/2013 6:00 PM	Members-Only Summer Movie Series: "Ice Age 4"
7/11/2013 10:30 PM	Read, Touch & Discover Preschool Program
7/18/2013 10:30 PM	Read, Touch & Discover Preschool Program
7/22/2013 12:30 PM	New Planetarium Shows Open
7/25/2013 10:30 PM	Read, Touch & Discover Preschool Program

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Belt Loop Day Registration

Thank you for your interest in the North Museum's Cub Scout Belt Loop Day. We have two Belt Loop Day events scheduled for Saturday, April 20, 2013 (Astronomy, Geology and Science) and Saturday, November 2 (Weather, Geography and Wildlife conservation). Please provide the following information below to complete your registration.

If you don't know exact number of scouts you're welcome to estimate and make changes closer to time by contacting Mike Smith at msmith@northmuseum.org or 717-291-4315.

If you experienced any problems with the online form, please let us know by contacting Mike Smith.

Registering as a...*	PackDenFamily
If registering as a Pack or Den, the Leader's name and contact info is needed below. Please make sure you select the correct date of the event you are wanting to register for. If registering for both events, you will need to fill out a separate registration for that second event.
Event Date
Pack Number
Pack Leader's Name
Den Number
Den Leader's Name

How many scouts will be attending?*
How many adults will be attending?*
How many children (non-Cub Scouts) will be attending?*

Your Name*
Address*
City*
State
Zip Code*
Primary Phone Number*
Secondary Phone Number
Email*
Are you a North Museum Member?	YesNo
How did you hear about Belt Loop Day?


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