Virginia Discovery Museum
Program Registration Form
Please print out and complete this form for each program registration. Mail to VDM Programs, PO Box 1128, Charlottesville, VA 22902
Child’s Name ________________________________ Child’s Age ______ Program________________ Date________ Cost _____
Adult’s Name ________________________________ Member: Yes No
Address_____________________________________________________________
_____________________________________________________________________
Phone ________________________ Email______________________________
Method of Payment |
|
____ |
Check |
____ |
Cash |
____
|
Visa |
____ |
MasterCard |
Credit Card #_________________________________
Exp. date ______________ VCode_______________ (3 numbers on back of card)
Signature____________________________________
Cancellation Policy: One week's notice is required for a full refund of all fees minus a $5 Processing Fee. If notification is less than a week before the start of the program, VDM will transfer the fee amount to another Museum purchase of your choice. The VDM reserves the right to cancel programs with insufficient enrollment and will fully refund fees from those programs.