JUNIOR ZOOKEEPER CAMP REGISTRATION FORM 2008
SESSION DATES FOR YEAR 2007:
Level I: June 30 - July 04; July 21 - 25; August 04 - 08;
Level II:  August 04 - 08;
Level III: July 11 - 15;
NOTE: Age 8 and up for all of the camps. Level I must be completed before Level II & III

JULY:

 ......//.......//...... AUGUST: .......//.........//........

 

 CHILD WILL BE USING THE BUS SERVICE

 

 CHILD WILL NOT BE USING THE BUS SERVICE
CAMPER INFO:
NAME .................................................................................................................
AGE: ...............................BIRTH DATE ..........//............//..........  (dd//mm//yy)
PARENT/GUARDIAN: ..................................................................................................................
ADDRESS: .................................................................................................................
CITY:  ..................................................POSTAL CODE:...................................
PHONE NUMBER: (H).................................................(W)..................................................
FAX NUMBER: ..................................................................................................................
  EMAIL ADDRESS: ..................................................................................................................
T-SHIRT SIZE: YOUTH:  (S) (M) (L) (XL)   ADULT:  (S) (M) (L) (XL)
How did you hear about Zoo Camp? (The Citizen, Capital Parent Magazine, At the Zoo, Friend, Other)

..........................................................................................................................................................

MEDICAL BACKGROUND:

YES NO PLEASE SPECIFY
ALLERGIES: ................................................................................................
REGULAR MEDICATION: ................................................................................................
MEDICAL DISORDERS: ................................................................................................
DISABILITIES: ................................................................................................
EXERCISE LIMITATIONS: ................................................................................................
EMERGENCY CONTACT:  ...................................................................................................................
PHONE NUMBER:  (H)............................................(W).........................................................
CHILD'S DOCTOR: ...................................................................................................................

ACCOUNTING:

CAMP FEE:  $ 285.00
GST: $  14.25
 TOTAL: $ 299.25

VISA     MASTERCARD   AMEX   CASH      CHEQUE   (Make cheques payable to Papanack Park Zoo.)        
CARD NUMBER: ................................................................................................................
EXPIRY DATE: .................................................................................................................
SIGNATURE: .................................................................................................................
Mail to:  150, County Road 19, Wendover, Ontario, K0A 3K0
Phone:      1 - (613)  673 - 7275 50% deposit required upon registration (non-refundable). 
Fax:            1 - (613)  673 - 5870 Balance due one week prior to session commencing. 
E-mail:    info@papanack.com Split payment: send two cheques, one with the current
date for registration and one dated for one week prior
to the commencement of the camp.