Aventuras National Zoo 2017 Field Trip Form

Aventuras is headed to the National Zoo!

Thursday, September 21, 2017 - 10:00 am to 4:00 pm

Smithsonian National Zoo
3001 Connecticut Ave. NW
Washington DC 20008

Child's Name*

First NameLast Name

My child has permission to go on this field trip.My child does not have permission to go on this field trip.

My child may ride on the bus.My child may ride on the bus and I would like to chaperone.I will drive my own child and I would like to chaperone.

No, I will not be bringing additional children or adults.Yes, I will be bringing one or more adults.Yes, I will be bringing one or more children.Yes, I will be bringing adults and children.

How many additional children will you be bringing?*

How many additional adults will you be bringing?*

Please list the name of the adult chaperone.*

First NameLast Name

YesNo

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

Please indicate any special instructions.

YesNo

Name of the parent/guardian completing this form.*

First NameLast Name

Email of the parent/guardian completing this form.*

I authorize a charge of $15 per person to be added to my next tuition payment to help offset the cost of transportation for this field trip. One parent per child may receive free admission if they are chaperoning a child in addition to their own. Additional family members are $15.