Camper Info Form • Summer : Education : Lincoln Children's Zoo

Please fill out one form per child registered for Zoo Camp. This information will only be shared with education staff to help ensure the safety of your child while attending camp. Thank you!

Camper/Contact Info

Camper's First and Last Name

First Name *

Last Name *

Parent/Guardian First and Last Name

First Name *

Last Name *

Parent/Guardian Address

Country

Address Line 1 *

Address Line 2

City *

State/Province *

Postal Code *

Parent/Guardian Phone Number (Required)

Parent/Guardian Email (Required)

Camp T-shirt

What age group is your child registered for?

4-5 Year Olds
6-7 Year Olds
8-9 Year Olds
10-12 Year Olds

What week is your child registered for? Select all that apply.

T-shirt Size

Please indicate if you would like a youth or adult size t-shirt.

Youth
Adult

Emergency Contacts

Emergency Contact #1 (Call First)

First Name *

Last Name *

Emergency Contact #1 Phone Number (Required)

Emergency Contact #2 (Call if #1 does not answer)

First Name *

Last Name *

Emergency Contact #2 Phone Number (Required)

Medications/Allergies

Camper Allergies
Please list any allergies. If none, write N/A.

Camper Allergies (Required)

Camper Medications
Please list any medications that your child will need to take during camp hours (8:30am -4:30pm). If none, write N/A. Please note we do not administer "as needed" medications.

Medications (Required)

Additional Info
Please list any additional information that may be helpful to our camp staff. If none, write N/A.

Additional Camper Info (Required)

Approved Pick Up

Please list anyone who is approved to pick up your camper.

Approved Pick Up (Required)

Please list anyone who is NOT approved to pick up your camper.

71uqy3w9rw3r

NOT Approved (Required)

Consent

The Zoo will be taking photos and videos of Zoo Camp. By checking this box, I understand that photos or videos of my child at Zoo Camp may be used for promotional purposes by the Zoo.

I understand

I give consent to Lincoln Children’s Zoo to apply the sunscreen my camper brings with them, I understand it is my responsibility to ensure my child has sunscreen on prior to arriving at camp. I also understand that by signing this waiver I am giving the Zoo permission to provide my child with sunscreen in the event they don't have any.

I consent
I decline