Alaska Zoo
2009/2010 Winter Adventure Camps
For Ages 9-12
Registration begins on Sept 14, 2009 and ends when camps are full.

For Registration Questions: Call (907) 346-2858 or email klarson@alaskazoo.org.

 

 Please select the events for your registration:
* Required Field

NameAgeDatesTimesFee
Non Passholders		Fee
Passholders
  

Registration Information:
Parent First Name: * Child First Name: *
Parent Last Name: * Child Last Name: *
Mailing Address: *    
City: *    
State: *    
Zip: *    
Current Age of Child: * Age on Date of Camp: *
Home Phone: * Work Phone:
Cell Phone:    
Email Address: *

(for emailed camp confirmation letter)
Are you a Current Passholder?:   Yes      No    
If yes, Passholder Number:  

To receive passholder discount, you must submit your pass number. We will check to verify that you are a current passholder.
   
List the Names of the person(s) authorized to pickup your child:

*

Emergency Contact Info:

In case of emergency, please notify (if you cannot be reached):

    
Name: *    
Relationship: *    
Phone: *    
       

Physician to be called in an emergency:

    
Name: *    
Phone: *    

Medical Information:

Please complete the following.  If not applicable, please type "none".
Physical limitations: *

* Note: We welcome attendees of all physical abilities.  The above information is to assist us with program and staff planning.
Allergies (however minor): *
Medications (please describe): *

* Note: All medications brought with the child must be mentioned to staff upon arrival.  Zoo staff will not administer medications.
Dietary Restrictions: *
Other Important information:

 
  

Zoo Release of Liability
I, the parent or legal guardian of the camp participant, do agree to assume all risk associated with participation in the Alaska Zoo Adventure Camps. I agree to advance release of the Alaska Zoo organization, board, staff and volunteers from any and all liability for property damage, personal injury or death.

I have read and agree to the release of liability policy. By accepting these terms through on-line submission, I am agreeing to the terms of this release.
 I Agree     I Disagree
  

Payment Information
Your camp spot is reserved upon submission of this completed form, however we need payment on-line by credit card or for you to mail your payment to us. Please select your method of payment:

 Payment Method: 

If you wish to pay by CHECK, mail your payment to the zoo at:
The Alaska Zoo c/o Camps
4731 O'Malley Road
Anchorage, AK  99507
Receipt sent by mail upon request.

Mailed Payments must be submitted to the zoo office within 5 Business Days of submitting this form. 

  

Your confirming Email will Provide a Total of the Amount Due
 

Refund Policy
Cancellations must be made in advance of 5 business days before the program date for refunds. Those made less than 5 business days before a program will result in no refund. If a program is cancelled due to enrollment, a full refund will be given.

I have read and agree to the payment and refund policy terms:
 I Agree     I Disagree