| AFRICAN SAFARI WILDLIFE PARK |
| 267 Lightner Road, Port Clinton, Ohio 43452 |
| Phone (419) 732-3606 or 800-521-2660 - Fax (419) 734-1919 |
| E-mail: LauraASWP@aol.com *
InfoASWP@aol.com |
| Become a
GUARDIAN OF WILDLIFE Get FREE Admission ALL YEAR LONG to AFRICAN SAFARI WILDLIFE PARK and FREE or DISCOUNTED Admission to over 100 Zoos and Aquariums. SAVE HUNDREDS of DOLLARS ! |
| TYPE OF MEMBERSHIP: | ___ New | ____ Renewal | Membership #__________________ |
MEMBERSHIP CATEGORY: (please check one below)
| _____ | @ $ 39.95 | =$_____________ | 2 admissions (any age) limit - one per household |
| _____ | @ $ 64.95 | =$_____________ | Family Pass (2 Regular Admissions (ages 7 & up) and 2 Child Admissions (ages 3-6) |
| _____ | @ $ 74.95 | =$_____________ | Family Pass 4 Admissions (any age) 2 and younger free |
| _____ | @ $ 10.00 | =$_____________ | For each additional person (of any age) added to a Family Pass only |
| TOTAL | =$ ____________ |
| NAME | . |
| SECONDARY NAME | . |
| ADDRESS | . |
| CITY, STATE, ZIP | . |
| PHONE/FAX NUMBER | . |
| . |
| Number of Regular Admission (Ages 7 yrs & up) _______ | Number of Children (3 - 6 yrs) _______ |
PAYMENT METHOD
| _____Check (Payable to African Safari Wildlife Park) | _____Visa |
| _____Discover | _____American Express |
| _____Cash | _____Mastercard |
| Credit Card Number:____________________________ | Expiration Date: _________________ |
| Signature | _____________________________________ | Date:______________ |
Please Fax this form to (419) 734-1919 or Call (800) 521-2660 ext. 9 Today for immediate use. We can (by request) fax a temporary card immediately. Otherwise you will receive your Membership by mail within 10 days. Upon request we can also have your card awaiting your arrival at African Safari Wildlife Park. This membership allows you and your family into 100's of Zoo's around the U.S. for Free or Discounted Admission. |
| For Office | Prepared/Review by: | Membership # |
| Use Only | Date issued: |