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2017 Central Park Zoo Camper Pick Up Form
This form provides us with a list of names of adults who are permitted to pick your child up from camp. All persons authorized to pick up your child must be over 18 years old. Be sure to include ALL guardians that are permitted to pick up your child, including yourself. Your child will not be released to an adult who is not listed on the Camper Pick Up form. No exceptions.
Please select the camp session that your child is enrolled in. *
Required
Child's First Name *
Your answer
Child's Last Name *
Your answer
Camp group (grade level)
Parent or guardian name *
Your answer
Parent or guardian phone number *
Your answer
Name of primary person picking up your child. *
Your answer
Telephone number
Your answer
Name of secondary person picking up your child
Your answer
Telephone number
Your answer
Additional person permitted to pick up your child.
Your answer
Telephone number
Your answer
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