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Outdoor Education & Wildlife Registration Form (page 1 of 2)
Print form & mail to: Ellijay Wildlife Rehabilitation Sanctuary
435 Cougar Lane
Ellijay, Georgia 30540
(706) 276-2980

Group/School Name:_______________________________________________
Address:________________________________
City:______________________ State:____ Zip:__________
Contact Person:___________________________________
Phone Day:_____________ Evening/Night:_____________
   
Requested Date. 1st Choice:_______________ 2nd Choice:_______________
Minimum Number Attending: Students under 18 yrs.____ Adults:____
   
Program Length:  
__Half Day __Full Day __Overnight
If overnight, specify:  
__Two Days/one night __Three days/two nights
__Four Days/three nights __Five Days/four nights
Location:
__ Our Location __ Your Location (day programs only)
   
Program(s) Desired:
Please note: If additional programs are requested on top of the Wildlife Identification & Rehabilitation (Large Animal & Small Animal) programs, a minimum full day stay will be necessary to accommodate all activities.

Sanctuary Members receive a 10% discount on all programs

__ Wildlife Identification & Rehabilitation (Large Animal Tour)
__ Wildlife Identification & Rehabilitation (Small Animal Amphitheater Program)
__ Aquatic Plant/Animal study __ Native American Village/Indians
__ Edible Plant Recognition __ Orienteering
__ Forest Life __ Ornithology/Bird Watching
__ Gold Panning/Geology __ Stargazing/Astronomy
__ Poineer Living & Village __ "Project Wild Games" Activities
__ "Georgia Project Learning Tree" Activities
Challenge & Adventure courses:
__ Overnight Camping in the Wild __ Team Building Ropes/Obstacle Courses
__ River Walk & Habitat Study __ Rock Climbing & Rappelling

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