K I D Z O O C A T I O N
All about
E G G S
Join us for this fun event which includes
the craft of painting eggs
Wednesday, May 23 10:00 - 11:30am
Zoo Education Center Classroom
75 Soden Road
Cost: $3 EFOZ members / $5 non-members
memberships available at the office
Kidzoocation is for children between the ages of 4 and 7
and we request 1 adult per 2 children attending
(please do not bring siblings who are not registered)
* * *PRE-REGISTRATION IS DUE BY NOON ON MAY 21st * * *
KIDZOOCATION REGISTRATION FORM for
A L L A B O U T E G G S
(please print)
Participant’s Name_________________________________________________Age________Phone_____________
Parent/Guardian’s Name____________________________________ Address_____________________________
City_________________________ State____ Zip _________ email ____________________________________
Waiver Statement
The undersigned, as parent or legal guardian of the registered participant states that he/she understands that the Emporia Friends of the Zoo, the City of Emporia, and the Emporia Zoo Docents are not and shall not be responsible or liable for any illness, injury to person or damage to property resulting from the Kidzoocation Activity, and the undersigned, on behalf of themselves, their heirs, executors and administrators, and the registered participant and their heirs, executors and administrators, do hereby remise, release and forever discharge the City of Emporia, Emporia Friends of the Zoo and the Emporia Zoo Docents from all claims, demands, actions or causes of action on account of any injury or illness to the participant or damage to property resulting from or during the Kidzoocation Activity and the attendance thereat, and does further waive any claim resulting from any photograph, photographic likeness or video tape taken of the participant while attending and participating in the Kidzoocation Activity and does further authorize the use of such photograph, photographic likeness or video tape by and as deemed appropriate by the Emporia Friends of the Zoo and the Emporia Zoo Docents.
Signature of Authorized Parent or Legal Guardian
___________________________________Date__________
For more information, please contact the Zoo Office at 341-4365 or
Erin Lingenfelter, Outreach Coordinator at
This e-mail address is being protected from spambots. You need JavaScript enabled to view it.
PLEASE MAIL FORM AND FEE (made payable) TO: EMPORIA ZOO DOCENTS / PO BOX 345 / EMPORIA KS 66801-0345
or
REGISTER AND PAY WITH PAYPAL
