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Topeka Zoological Park
Michael D. Coker, Zoo Director
Topeka Zoological Park - Map
635 SW Gage Blvd
Topeka, KS 66606
785-368-9131
785-368-9152 FAX
mcoker@topeka.org
Note: Some fields are required
Shirt Size: (Camp Peka Sue Only)
Address: City: Zip:
Parent/Guardian:
Work Phone: Home Phone:
Do you or your child require a reasonable accommodation in order to participate in the program? Requests must be made 2 weeks (ideal) in advance by filling out a Special Needs Statement and Request Form.
In Case of Emergency call: Phone:
The following individuals are authorized to pick up my child:
Parent/Guardian Signature: Date:
Child's Physician: Hospital Preference:
Please list all allergies and medications:
FOTZ member?:
*Refunds will be made only if the class is full or is cancelled by the Education Department.
Notice: The number displayed below is to confirm entry submission.
6957
Last Updated:

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