KidLife Zoo Day

Please fill out this form and click submit.

Please fill out a form for each child.
Please send a sack lunch and drink with your child.

(a release form is required for each student, please obtain form from KidLife or download from website)

Parent Name

*

Email

*

This address will receive a confirmation email

Phone

*

Child's Name

*

Age/Grade

*

Please select one option.

Pre-K 3 (Parent attendance required) Pre-K 4 (Parent attendance required K 1st grade 2nd grade 3rd grade 4th grade 5th grade

Adult name attending with Preschooler:

How did you hear about this event?

*

Please select one option.

Church Friend Online

Payment

1 child ($16) 2 children ($32) 3 Children ($47) Will Pay in Person (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form and click submit.

Please Fix the Following

Close