ECHO at the Zoo
ECHO Family Care Partners is hosting a community event in partnership with New Ground Charities on June 1st at the Virginia Zoo in Norfolk. We are gathering sponsors to cover ticket costs, to make this a FREE event for ECHO families (as well as social workers). This form does not ensure your ticket but puts you on the list to request free tickets. We will email your admission ticket a week before the event. If you register and then are unable to attend, please let us know ASAP, as we have a limited number of tickets to give away. 
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Name *
Phone Number *
We will contact you with updates via text.
Email address *
We will email your admission tickets prior to the event, based on ticket availability.
Please enter your caseworker's name and agency. *
If you do not have a caseworker, enter 'None'.
Please list TOTAL number of tickets requested, for ages 2 to adult. *
Include all adults and children aged 2 and older.
Thank you for joining this at this event! PLEASE READ THE FOLLOWING CAREFULLY before signing this waiver of liability. By requesting tickets to attend ECHO at the Zoo, I release ECHO (and its board of directors, officers, employees, and agents) from any and all liability, claims or actions that may arise from injury or harm to myself, my dependent(s), or damage/loss to my property, in connection with the event. I recognize that this Release means I am giving up, among other things, the right to sue ECHO  related to this event, its board of directors, officers, employees, or agents for injuries, damage, or losses I or my administrators, and assigns, as well as myself and my dependent(s). *
Required
By checking the box below, I acknowledge  understanding this form does not ensure free tickets to the zoo, but puts my family on the list to REQUEST free tickets. I understand that I may not receive free tickets to the zoo (although ECHO will attempt to meet the needs to the best of their ability). Furthermore, I agree to notify ECHO if my availability changes and my family is no longer in need of or able to attend the zoo event. *
Required
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY AGREEMENT, FULLY UNDERSTAND ITS TERMS AND FULLY UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS FOR MYSELF AND THOSE FOR WHOM I HAVE ASSUMED RESPONSIBILITY. BY TYPING MY NAME BELOW AND SUBMITTING THIS FORM, I FREELY AND VOLUNTARILY AGREE TO THESE TERMS.I AGREE AND ACCEPT RESPONSIBILITY *
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