Shedd Stewards Spring 2014

*1.
Question - Required - Please select which date(s) you are available to attend. (If you register for a date and have to cancel later, contact the program staff prior to the event date. Failure to do so will prohibit the student from future registration.)
Please make at least 1 selection from the choices below.

 

Parent/Guardian information:

2. About Parent/Guardian:

*

Name:

 

 

 

     

*

 

 

What's this?

3.  


*4.  


*5.  


6.  


 

Participant information:

*7.  


*8.  


*9.  


*10.  


11.  


*12.  


*13.  


*14.  


*15.
Question - Required - Date of birth:




*16.  


*17.


18.


*19. Ethnicity:
(Select one of the available choices or enter a different value.)



 

School information:

*20.  


21.  


22.  


23.  


24.  


*25.


 

Emergency Contact #1

*26.  


*27.  


*28.  


*29.  


 

Emergency Contact #2:

30.  


31.  


32.  


33.  


 

Drop-off and Pick-up Information/Waiver:

Please review the Drop-off/Pick-up Waiver (PDF) below before answering the questions in this section.

Participants are to be dropped off between 8:30 and 9 a.m. each day at the aquarium's bus turnaround (located on the south side of the aquarium, where Museum Campus Drive meets westbound Solidarity Drive). Pickup takes place at 4 p.m. at the same location.  

To ensure the safety of your child while participating in Shedd Aquarium programs, the aquarium requires that an authorized parent or guardian sign an attendance register when dropping-off and/or picking-up a child under the age of 18. Staff and volunteers will not release a child to anyone other than an authorized parent or guardian unless written authorization from a parent or legal guardian is on file with the aquarium. Individuals arriving to pick-up a child must produce a valid, unexpired photo ID as proof of identity. Please provide the following information for individuals to whom you authorize Shedd Aquarium to release your child. 

Parents or guardians can update this information with staff when dropping off their child on the first day of camp. 

*34.


 

If no (you are requiring that they are picked up and dropped off by an adult), fill out the information below.

35.  


36.  


37.  


38.  


39.  


40.  


41.  


42.  


43.  


 

Consent and Release Information

Please review the documents below before answering the remaining questions.

Photo Consent Waiver (PDF)
Communication Waiver (PDF)
Release Waiver (PDF)
Evaluation Waiver (PDF) 

*44.


*45.


*46.


*47.


48.  


 

By providing my electronic signature in the space provided, I ACKNOWLEDGE that I have read all Consent and Release forms prior to signing them and that I understand their contents.

49.  


   Please leave this field empty