Potawatomi Zoo - Pokagon Registration Form

JOIN THE POTAWATOMI ZOOLOGICAL SOCIETY

And receive FREE admission to the zoo for one year!

Please allow 10 business days for processing online zoo memberships.

Submitted payments and memberships are non-transferable and non-refundable.

Once you submit your credit card information, you will receive an e-mail verification/receipt from onlinepayment@potawatomizoo.org.

About You
	Primary Adult
First Name:
MI:
Last Name:
# of children under age 18 on your membership:
	Secondary Adult
First Name:
MI:
Last Name:
Your Address
Address:
City:
State:
Zipcode:
Home Phone:
Work Phone:
E-mail Address:
	Yes, I'd like to receive occasional e-mail updates, news and future discounts from the Zoo. The Potawatomi Zoo will not share, sell or trade your e-mail address with any third parties.
Membership Level
Please choose from the following membership levels:	$17.50 - Senior $17.50 - Student $25.40 - Individual $38.50 - Grandparents $42.00 - Family
More Options:
	$15 - Add a guest to any category above Please write your additional member's name in the space provided. Guest Name: If you would like to bring an unnamed guest each visit, please write "Guest" in the Guest Name box above. Your unnamed guest must be accompanied by one of the two adults on your membership. $15 - Add a Conservation Book

Promotions:
Promotion Code:	(Please enter your 3-digit Promotion Code)
Security Check: