We invite you to join us this summer on an Adventure you'll never forget.  Join your local group by completing the form below.  

Students will need a parent to complete this form with them.  Did you know that students can earn a $100 tuition discount by signing up before March 31st, 2010, or by referring a friend to Earth Explore?  Find out more   Just need to make a payment on an existing account? Click here.

After signing up, you'll be directed to a secure payment page to make a deposit by credit card.  If you'd like to submit a deposit by check, or mail your registration, please print and complete the pdf application.

	Student Registration Form 2010
	*Required
	*Adventure Choice	Alaska Adventure Costa Rica Adventure Big Island (Hawaii) Adventure Italy Adventure Tetons and Yellowstone Adventure Yosemite and Monterey Adventure
	Student's Information
	*Student's First Name			*Last Name
	Preferred name			*Gender	Female Male
	*Home Address			*City
	*State			*Zip
	*Home Phone			Parent Cell
	*Email address			*School
	*Current Grade	6 7 8 9 10 11 12		*School City
	Teacher leading local group			School Year Ends
	Adult T-Shirt Size (select one)	Small Medium Large Extra Large
	Parent/Guardian Information
	*Father's name			Address	If different from student
	*Mother's name			Address	If different from student
	*Emergency Contact (besides parents)			*Phone
	Student's Other Information
	Interests and Hobbies			Favorite subject?
	*Allergies, food needs	Parents, list known allergies or special food needs
	Referred by a friend?	Yes No		If yes, name of friend who referred you
	Like to Recommend a Teacher?			School
	Deposit Information
	Name on Credit Card to be used (for cross referencing payment)
	By submitting this form I acknowledge that I have read and agree to the program Terms and Conditions, as well as the Student Rules and Guidelines. pdf
		Credit Card deposit required to complete application.