Camper Info Form : 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 (Required)

Parent/Guardian First and Last Name (Required)

Parent/Guardian Address

Country

Address Line 1 *

Address Line 2

City *

State/Province *

Postal Code *

Parent/Guardian Phone Number (Required)

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Parent/Guardian Email (Required)

What age group is your child registered for?

Kindergarten & 1st Grade
2nd & 3rd Grade
4th & 5th Grade

T-shirt Size

Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL

Emergency Contacts

Emergency Contact #1 (Call First) (Required)

Relationship to Camper (Required)

Emergency Contact #1 Phone Number (Required)

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

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.

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.

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

By checking this box, I acknowledge that participation in any Zoo program exposes my child to certain risks and dangers and accept any and all risks associated with my child attending Zoo Camp.

By checking the "I Understand" box, I acknowledge and agree that I have fully read, understand and voluntarily sign this release of liability.

I understand