Wildlife Images Rehabilitation & Education Center

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for joining our Wolf Pack! This weekend day camp is a unique, fun, and engaging way for local teens to grow and share their knowledge of zookeeping. We’re so glad your child will be joining our pack!

PLEASE read the Wolf Pack Handbook before signing your child up for the program.

JOIN OUR WOLF PACK

Your child may join our pack on a Quarterly (3 month) basis. Each month, you will choose which sessions work best for your busy schedule. Wolf Pack is a full inclusion experience, with our pack learning everything from animal husbandry to training. They will shadow keepers, enjoy science lessons and more as they experience true zookeeper life.

Are you a member? Email education@wildlifeimages.org for your special member code BEFORE registering and receive 10% off.

There are Scholarships available! Please fill out our Scholarship Form BEFORE registering for Wolf Pack. Wildlife Images cannot refund the difference after you register.

WOLF PACK 2ND QUARTER

$500.00

2nd quarter includes up to 10 Pack Sessions, December 2023 - February 2024.

Discount Code

Total: $0.00

PLEASE SELECT THE PACK SESSIONS YOU WOULD LIKE TO ATTEND:

Pack sessions are offered Saturdays from 10am-3pm. Pack members are invited to attend just a few or all ten sessions per quarter! It's up to you what works best for your busy schedule.

Registration Information:

Registrant Name: *

Birthdate: *

Current School: *

Shirt Size *

Medical Information:

Please list any medical conditions, allergies, special considerations or dietary issues, etc. we should be aware of. Due to the nature of the programming, facility, and staffing, Wildlife Images regrets it may not accommodate students who are medically fragile, or on an IEP or 504 Plan without prior approval. Ineligibility for programming is at the discretion of Wildlife Images staff. Requests for special accommodations will be considered on a case-by-case basis with prior notice so we can discuss how to best accommodate your camper’s needs. To discuss special accommodations, please email education@wildlifeimages.org

Parent / Guardian Name & Relationship to Registrant: *

Parent / Guardian Telephone: *

Parent / Guardian Email: *

This email will receive registration confirmation, session changes, and class information.

Participant Release Form: *

I am the participant’s (named above) parent or legal guardian. I represent to WIREC that I have the authority to execute this release, and that I will hold WIREC harmless from any and all claims or demands that may arise from this release. I hereby authorize the teacher, supervisor, or designated representative of WIREC to either call emergency services or transport and admit my child to a medical facility and arrange for my child to be provided with emergency treatment by a licensed physician. I fully understand & accept that my child & I are not covered by any insurance pertaining to Wildlife Images, or guaranteed medical payment coverage which would compensate should I or my son/daughter be injured. I authorize and consent to my child being transported, by means selected by WIREC, for field trips and/or to and from home. I fully release, discharge, and hold harmless forever, Wildlife Images, its corporation officers, board of directors, staff, & volunteers, from all things, acts, omissions, and conditions which may cause me or my child, injury or any other problems.

Restrictions & Requirements *

I have read and understand the Wolf Pack Handbook, including the cancellation and refund policy

Image Release: *

I hereby give my permission for images of my child, taken during Wildlife Images (WIREC) activities through video, photo and digital camera, to be used for the purpose of WIREC’s promotional material and publications, and waive any rights of compensation or ownership there to.

Emergency Contact Information:

We will contact the parent or guardian first. This should be a SECONDARY emergency contact in case we cannot contact the guardian.

Emergency Contact: *

Phone Number: *

Relationship To Registrant: *

Who, other than yourself, is authorized to pick up your child from Wildlife Images?

Name:

Relationship To Registrant:

Name:

Relationship To Registrant:

Name:

Relationship To Registrant:

Self-Transport Permission:

My child is of legal age and has a valid drivers license (not permit) and has guardian permission to drive themselves to and from Wolf Pack Sessions

Payer Information:

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

How did your hear
about us?

Your Payment Information:

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *