Participant's (child) Information:

T-Shirt Size:

Box Lunch Options:

Please place a check mark by the sandwich choice. Each box lunch contains the following: Sandwich, Go-gurt, Ritz cheese crackers, Rice Krispie Treat, Animal Crackers and choice of Water or Capri Sun.

Parent(s) or Guardian(s) Information:

Medical Information:

Weather:

Pine Grove Zoo’s camps are held regardless of rain or shine. Please dress appropriately for all sorts of weather. If the weather become severe, all participants will be in a safe indoor area.

Emergency Contact Information:

In case of emergency, please provide 3 different contacts and phone numbers that an adult can be reached at:

Agreements:

Cancellation/Refund Policy:
Cancellations must be made in writing two weeks prior to the day of camp. 50% of the fee will be refunded upon written cancellation notice. 100% of the registration fee will be refunded if Pine Grove Zoo cancels the camp.

Authority to Photograph or Video Tape:
Permission is given for the applicant to be photographed or videotaped for education and related promotions. All photos and videos remain the property of Pine Grove Zoo.

Consent:
I hereby give consent for the applicant to participate in Pine Grove Zoo’s Day Camp Program. I understand that there are risks involved when working in a zoo environment and I will not hold Pine Grove Zoo or it’s staff or volunteers responsible form any injury arising from the applicant’s participation in this program.

I have read and understand the enclosed information about the Zoo Day Camp Program. I also confirm the information provided by the applicant/guardian is accurate.

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