Pre-K - The Incredible Cassowary

Child Information

• * First Name:
• * Last Name:
• * Email Address:
• * Confirm Email Address:
• * Address 1:
• * City:
• * State: --Choose-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -------------- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
• * ZIP Code:
• * Phone:
• Cell Phone:
• * Age --Choose-- 4 5
• * Grade Completed in May 2018 --Choose-- Pre-K
• * Shirt Size --Choose-- Youth XS Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL

• Fee

  Type	Fee
  Non-Member	$115.00
  FOTAZ Member	$95.00

Allergies or Restrictions

• * List any allergies or restrictions.

Additional Child Information

You may add a maximum of 2

Parent / Guardian Info

• * Parent / Grandparent / Guardian Name
• *

  Are you a current FOTAZ Member?

  • No
  • Yes
• FOTAZ Member 6-digit Number (located below barcode on your card)

• By submitting this form, I understand that Alexandria Zoological Park may use pictures and/or video of my child taken during Summer Safari for promotional and news purposes.

• For registrations received after May 4, shirt size is not guaranteed.