
Parent/Guardian Contact Information*:
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Full Name Daytime phone number Email address
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Membership Affiliation*:
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Camper Information*:
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Camper's Full Name Camper's age at the start of camp Camper's gender Please list any health issues, allergies, physical or behavioral conditions which staff should be made aware:
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Camper 2 Information:
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Camper's Full Name Camper's age at the start of camp Camper's gender Please list any health issues, allergies, physical or behavioral conditions which staff should be made aware:
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Camper 3 Information:
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Camper's Full Name Camper's age at the start of camp Camper's gender Please list any health issues, allergies, physical or behavioral conditions which staff should be made aware:
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Camper 4 Information:
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Camper's Full Name Camper's age at the start of camp Camper's gender Please list any health issues, allergies, physical or behavioral conditions which staff should be made aware:
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Email me about upcoming programs*:
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Yes
No
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How did you hear about our camps?*:
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Previously attended a Lauritzen Gardens camp
Lauritzen Gardens website/ad/newsletter/email
Fontenelle Forest website/ad/newsletter/email
Omaha's Henry Doorly Zoo & Aquarium website/ad/newsletter/email
Internet search
Family Fun in Omaha
Momaha/Omaha World-Herald
Omaha Moms Blog
Word of mouth
Other (please specify below)
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Other source of information:
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Lunch Options (full-day camps only)*:
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Lunch prepared by the cafe, includes meat
Lunch prepared by the cafe, vegetarian option
For medical/allergy/personal reasons, my camper will bring their own lunch
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Past Camp Participation*:
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Lauritzen Gardens
Fontenelle Forest
Omaha's Henry Doorly Zoo & Aquarium
None
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When do you plan for summer camps?*:
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December
January
February
March
April
May
June
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