Bug Adoption Form

Personal Information	
First Name: 	Last Name: 	
Address:	
Email: 	
Payment Method:	Date:	

I am adopting for:	
□ Myself	□ Someone Else	□ In Memory Of	□ A Group	

Name to Put on Certificate: _____________________________________

I am adopting a $40 bug:	
□ Peppered Cockroach - Archimandrita tessellate	□ Hissing Cockroach - Gromphadorhina portentosa	
□ Cave Dwelling Cockroach - Blaberus giganteus	□ Frog Legged Beetle - Sagra longicollis	
□ Fighting Stag Beetle - Hexarthrius parryi	□ Giant African Millipede – Archispirostreptus gigas	
□ Asian Millipede - Thyropygus pachyurus	□ Giant Spiny Stick Insect - Eurycantha calcarata	
□ Peruvian Black Beauty - Peruphasma schultei	□ Persian Sapphire Beetle - Cetonischema speciosa cyanochlora	
□ Whip Spider - Phrynus whitei	□ Dead Leaf Mantis – Deroplatys lobata	
□ Giant Land Snail- Lissachatina fulica		

I am adopting a $50 bug:	
□ Atlas Rhino Beetle – Chalcosoma atlas	□ Hercules Beetle - Dynastes Hercules	
□ Goliath Beetle - Goliathus goliatus	□ Jungle Nymph – Heteropteryx dilatata	
□ Brazilian Blue-Violet Tarantula** - Pterinopelma vitiosum	□ Trinidad Chevron Tarantula** - Psalmopoeus cambridgei	
□ Mexican Red Knee Tarantula** - Brachypelma smithi	□ Cameroon Red Baboon Tarantula** - Hysterocrates gigas	
□ Salmon Pink Bird-eating Tarantula** - Lasiodora parahybana	□ Peruvian Black Bird-eating Spider** - Pamphobeteus nigricolor	
□ Mexican Red Rump Tarantula – Tliltocatl vagans	□ Curly Hair Tarantula – Tliltocalt albopilosum	
□ Snowflake White’s Tree Frog** - Litoria caerulea	□ Mexican Red Leg Tarantula – Brachypelma emilia	
□ Amazon Milk Frog** - Trachycephalus resinifictrix	□ Red-eyed Tree Frog** - Agalychnis callidryas	
□ Peacock Day Gecko** - Phelsuma quadriocellata	□ Gold Dust Day Gecko** - Phelsuma laticauda
	
**Already named – will not be included in adoption package

Name for Adoptive Bug: ________________________________________________ 
*Please inform an employee if you live outside of Sault Ste. Marie.
Your Package Will Include:
•	A certificate of adoption
•	A framed picture of your bug species
•	A new name for your adoptive bug (when applicable)
•	Quarterly updates on your adopted bug (email required)
•	A small thank you card

DISCLAIMER: Please take note that since most of the animals at Entomica have shorter lifespans, there is a possibility of your adoptive pet passing away before your updates have been completed. If this is the case, you will be notified immediately and will be given a new bug of your choosing for the remainder of the period. If possible, a new individual of the same species will be gifted. However, in certain cases this will not be possible, in which an individual of a species of our choosing will be gifted, provided it is not of a higher pay tier.