Abilene Zoo Summer Camp 2018Registration FormCamps 4222
Guardian or Parent’s Name: ______Phone: ______
Email address: ______Member: Y N
Camper: ______grade ______youth shirt size: xs sm md lg xlg
Camper: ______grade ______youth shirt size: xs sm md lg xlg
Preschool Ages 3&4: 9am - noon
Alpha Zoo:June 18-22FULLJuly 23-27FULL
Backyard Friends:July 9-13 FULL August 6-10 FULL
Ages 5-5th gradesCamp times 9-3. $145 members/$160 non-members
Party Animal:August 13-17 FULL
Creature Camp:August 21-24FULL
Ages 5 &Kindergarten:Camp times 9-3. $145 members/$160 non-members
Dinosaurs: June 11-15 FULLJuly 23-27 FULL
Home Sweet Home:June 25-29 FULL
Feather Frenzy:July 9-13_____
Entering 1st:Camp times 9-3.
Bird Brains: June 18-22 FULLAugust 6-10 FULL
Prehistoric Critters:July 2-6 FULL
Terrific Texas:July 23-27 FULL
Entering 2nd or 3rd Grade:Camp times 9-3.
Jungle Adventures: June 11-15 FULLJuly 30-Aug 3 FULL
Wild About Texas:July2-6 FULL
Radical Raptors:July 16-20 FULL
Entering 4th or5th Grade:Camp times 9-3. $145 members/$160 non-members
Rainforest Ramble:June 25-29 FULLAugust 6-10 FULL
Texas!:July 9-13 FULL
Wild Designs:July 16-20 FULL
Entering 6th or 7th Grade: Camp times 9-3. $145 members/$160 non-members
Enrichment Engineers:June 18-22_____
Texas!:July 9-13 FULL
Junior Zoo Keeper:July 30-Aug 3 FULL
______
Cancellation Policy: If unable to attend a scheduled camp, please notify us within two weeks of the camp start for a refund, less a $10 cancellation processing fee. No refunds will be given for unattended days of camp.
TOTAL: ______Payment enclosed _____ Call for Credit Card information_____
PLEASE COMPLETE THE RELEASE FORMS ON NEXT PAGE
Send completed forms by: Fax (325-676-6084), email (), mail (2070 Zoo Lane, 79602) or bring by in person
CAMPER(S) ______
Medical Release
In the event of an emergency, I hereby give the Abilene Zoo and its employees permission to seek medical attention for my child/dependent ______.
______
Signature Date
Emergency contact information: Home and/or cell phone: ______
***Other medical information you feel necessary for the staff to know – please include any allergies:
______
Please list every individual other than yourself that is allowed to pick up your child. Those picking up your child will be required to sign your child out. Those not on the list will not be allowed to pick up your child without previous permission.
Release Agreement for Camp Participation
I, ______, parent/legal guardian of ______hereinafter referred to as the participant; request that the City of Abilene and the Abilene Zoological Society allow my child/ward to participate as a camp participant in the Zoo Camp provided by the City of Abilene and the Abilene Zoological Society. I further acknowledge that I understand that this is not a State Licensed program.
There are physical risks involved in participating in the program, including but not limited to injury inflicted by animals. The participant’s parent/legal guardian agrees to release indemnify, hold harmless and defend the City of Abilene and the Abilene Zoological Society, and their officers, agents, and employees, from and against liability for any and all claims, liens, suits, demands, and/or action for damages, injuries to persons, including death, property damage (including loss of use), and expenses (including court costs and attorney's fees), and other reasonable costs arising out of or resulting from the participants participation in, connection with, or incidental to this camp, including, but not limited to, all such causes of action based upon common, constitutional or statutory law, or based in whole or in part upon the negligent or intentional acts or omissions of the City of Abilene, Abilene Zoological Society, or the participant, including but not limited to his/her/its heirs, executors or assigns.
By signing this release/agreement, the participant’s parent/legal guardian hereby warrants that he/she has read and understands the release/agreement. The participant’s parent/guardian's signatures are affixed hereto of his/her own free will without any inducement or reliance on any person or promise. The participant’s parent/legal guardian further warrants that he/she is of legal age and legally competent to execute this release/agreement.
______
Parent or Legal Guardian SignaturePrinted NameDate
By participating in this program I allow my child’s photo to be used for promotional purposes.
Opt in ____ Opt out____