Larimer Humane Society Critter Camp Questionnaire

Parent/Guardian Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Phone*

Emergency Contact Name*

Emergency Contact Phone Number*

Drop Off/Pick Up Contact Information*

Please provide a name and phone number - ID required to pick up and drop off.

How did you hear about Critter Camp?*

Camper Information

The questions in the below section relate to the camper.

Camper Name*

First Last

Date of Birth*

Pronouns*

Date of last tetanus shot*

Dietary Restrictions*

If you have a restriction that isn't listed below, please email education@larimerhumane.org.

Does your camper have any allergies we should be aware of?*

What school does the camper attend?*

Are there any companion animals residing with the camper?*

If you answered ‘Yes’ to the previous question, please describe them here (two cats, one snake, etc)

Anything else we should know about your camper?