Reid Park Zoo Summer Camp Waiver Form

Health, Emergency Contact and Waiver of Liability Form-Summer Camp 2025

This must be filled out by the parent/guardian of any camp participant AFTER you have registered for camp. You must fill out a separate form for each camper. AOL AND YAHOO EMAIL USERS – Please note that this form may not send correctly from these accounts. Please call 837-8200 to confirm we have received your form if using an AOL or YAHOO email. Thank you!

Health, Emergency Contact, and Waiver of Liability Form – Summer Camp 2025
General Information
Parent/Guardian's Name*
First Last
Best Phone Number to Reach You*
Best Email*
Camp Participant's Name*
First Last
Camper's Preferred Name (to put on nametags)*
First
Camper's Preferred Pronouns
Camper's Date of Birth*
Camper's Age*
Camper T-Shirt Size*
Camper's Grade Fall of 2025*
Week Participant Will Attend Camp*
Week Participant Will Attend Camp
Days Participant Will Attend Camp
Camper's Favorite Animal
Who has permission to pick your camper up from camp? (Please note an individual must be on the list below to pick up a camper and they must show their photo ID when they arrive.) Please list first and last name and provide a phone number for each individual.*
Has your child attended a Reid Park Zoo Camp before? If so, when?
How did you hear about our camp?
I understand I am responsible for providing a bag lunch (unless I am ordering from the Flamingo Grill ahead of time) and two snacks per day for my camper and there is no lunch during half day camps.*
- Yes I do
Health Form
Please share any medical, physical, cognitive, or behavioral conditions which would be important for instructors to know.
If your camper needs to bring their own sensory tools, please list what those are below and send those with your camper each day.
Zoo Camp is fun and exciting and can, at time, lead to heightened emotions. Please let us know how to best support your camper should they become overwhelmed or overstimulated.
If your camper has any dietary or activity restrictions, please list those below.
Primary Contact's Name*
First Last
Relationship to Participant*
Primary Phone*
Secondary Phone
Is the participant taking medication?*
- Yes
- No
Name of medication(s)
Will medication(s) be taken during program hours?*
- Yes
- No
Medication Permit
The following information relates to your responsibilities if your child requires medication(s): 1.) For each medication required, a Medication Permit must be filled out and signed. Staff will not administer any medication that does not have a signed permit, including non-prescription medications. NO invasive medical procedures will be administered. 2.) All prescription medications must come in a pharmacy bottle with a legible pharmacy label on it. The label must contain the participant’s name, the pharmacy’s phone number, the name of the medication, dose and frequency required, and the doctor’s name. 3.) All non-prescription medications must be submitted in the original sealed container with the participant’s name, dose, and frequency clearly labeled on the container.
Name of Medication*
Dosage*
Name of Doctor*
Please identify the condition this medication was prescribed for*
Instructions for Giving Medication*
Possible Side Effects*
By initialing below, I hereby authorize Zoo Summer Camp Staff to give the above named medication to my child.*
Emergency Contacts
Please provide 2 emergency contacts
1. Contact's Name*
First Last
Relationship to Participant*
Primary Phone*
Secondary Phone
2. Contact's Name*
First Last
Relationship to Participant*
Primary Phone*
Secondary Phone
Permissions
I authorize the Staff of Reid Park Zoo to request emergency treatment for my child if the situation warrants it and I am unable to be contacted.*
- Yes I do
I authorize the Staff of Reid Park Zoo to administer Basic First Aid to my child if necessary.*
- Yes I do
I hereby grant Reid Park Zoo permission to record the participant’s likeness and/or voice for use in television, social media, radio, or printed materials to further the aims of the Zoo in related campaigns and in other ways they may see fit.*
- Yes I do
- No I do not
By entering my initials below, I release and hold harmless the Reid Park Zoo, Reid Park Zoological Society, the City of Tucson, and employees or agents thereof, from any and all claims, liabilities, or demands whatsoever arising out of the enrollment or participation in any program by the participant herein.*
Summer Camp Behavior Policy
By entering my initials below, I verify that I have read the Reid Park Zoo's Camp Behavior Policy*
Parent/Guardian Signature*
Please enter your name in the box to serve as your digital signature.
Date*
MM slash DD slash YYYY

Reid Park Zoo Summer Camp Waiver Form

Health, Emergency Contact and Waiver of Liability Form-Summer Camp 2025

Health, Emergency Contact, and Waiver of Liability Form – Summer Camp 2025

General Information

Health Form

Medication Permit

Emergency Contacts

Permissions