2024 Boerne Animal Academy Registration Form

Boerne Animal Academy Registration

Complete this form to register your child for the summer 2024 Boerne Animal Academy hosted by Boerne ACS.
Registration must be completed by a parent or legal guardian. If you are registering more than one student, please complete a separate form for each student.

Who: Camp is open to students entering 6th - 8th grade in the fall.

When: Camp sessions will be on the first four Saturdays in June from 11 a.m. - 12:30 p.m.

Where: Boerne Police Department Training Room, 124 Old San Antonio Road

Session Topics:
- June 1: Veterinarian and Police K9 Demonstration
- June 8: Animal Care and Exotics
- June 15: Presentation by San Antonio Zoo staff
- June 22: Domestic Animal Education featuring Happy Tails Petty Zoo
If you have any questions, please email Boerne ACS or call (830) 249-2456.
Student Information
Student's Name

First NameLast Name
Birth Date

MonthDayYear
Grade in 2023-2024 School Year
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the student have any allergies, chronic illness, or medical conditions we should be aware of? If yes, please describe.
Parent/Guardian Information
Name

First NameLast Name
Home Number
Format: (000) 000-0000.
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Parent/Guardian Acknowledgement and Signature
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the City of Boerne during the Boerne Animal Academy camp. In exchange for the acceptance of said child’s candidacy by the City of Boerne, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the City of Boerne and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against the City of Boerne including all staff, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature of Parent/Guardian
Date

MonthDayYear
Date
Should be Empty:

Boerne Animal Academy Registration

Student Information

Parent/Guardian Information

Emergency Information

Parent/Guardian Acknowledgement and Signature