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sign up today! event highlights

All registered walk participants will receive:

• Unique opportunity to walk through the World-Famous San Diego Zoo before it opens to the public • Great event T-shirt and goodie bag • FREE admission to the San Diego Zoo on Saturday, October 9 • Meet and greet Joan Embery and her critters • Fun post-walk expo with activities and refreshments • Opportunity to collect pledges and earn great prizes

2.5 Wild Miles of Fun and More Fun

The 5th annual Walk on the Wild Side will benefit our own elephant herds at the San Diego Zoo and Wild Animal Park as well as our elephant conservation projects in the field. Habitat loss and poaching are major threats to the species’ survival. The San Diego Zoo is committed to ensuring the survival of all elephant species and is already an active force in elephant conservation. Your support will allow us to continue our conservation efforts for elephants both at home and in the wild.

SATURDAY, OCTOBER 9, 2010 7:30 a.m. • San Diego Zoo Walk on the Wild Side Entry Form

Entry Fees: Please check appropriate box(es)

Please use one form for each paying participant. OK to photocopy. Do not reduce.

Adult Registration

First Name

Gender M F

Postmarked by 9/26/10*................................. $25 After 9/26/10................................................... $30

Last Name

Age on 10/9/010

T-shirt Size (circle only one) Adult: S M L XL XXL Youth: Small (6-8) Medium (10-12)

D.O.B (MM/DD/YR)

Street Address

City

State

Zip Code

Child Registration - 11 and Under Postmarked by 9/26/10*................................. $15 After 9/26/10................................................... $20 * Register by 9/26/10 and be entered to win a family four pack to a Rore & Snore Sleepover at the Wild Animal Park.

I’d like to make a donation in the amount of X

Day Phone

$_________ (include in “Amount Enclosed” total)

Yes, I plan to raise money for the San Diego Zoo and elephants. I will collect pledges online at www.sandiegozoo.org/walk/

E-mail

Current Zoological Society Member (check one): Yes

No

EVENT WAIVER AND RELEASE

(Participant must sign to be eligible to participate in the event): I, participant, on my own behalf, do for myself, my heirs, executors, administrators and assigns, agree that the Zoological Society of San Diego, the City of San Diego and their directors, officers, employees, agents, and volunteers (collectively the released parties) shall not be liable for any damages arising from personal injuries (including death), damage to or loss of property or other harm, whether foreseen or unforeseen, present or future, known or unknown, that I may sustain in any way which directly or indirectly results from or arises out of my participation in the program or presence at the program site (collectively the claim). I, participant, on my own behalf, understand that this release, waiver and discharge includes any claim based in whole or in part on the present or future negligence, action or inaction of any of the released parties. I will permit the use of my name and photos in broadcasts, telecasts, newspapers, brochures, etc., for promotional purposes without compensation. I also understand that the entry fee is nonrefundable. I have read the entry information provided for the event and certify my compliance by signature below. I agree to indemnify and hold the Zoological Society of San Diego and its officers and employees harmless for any claim or demand, including reasonable attorneys’ fee, made by any third party due to or arising out of the violation of any terms of this Liability Waiver. I agree to jurisdiction in the State of California and that the laws of California shall govern any dispute between the released parties and me. If participant is under the age of 18, this form must be signed by the participant’s parent or legal guardian. ________________________________________________________________________________________________________________________ Participant’s Signature Date ________________________________________________________________________________________________________________________ If Participant is a minor, Participant’s Parent or Legal Guardian’s Signature Date Please refer to the Web site for a complete set of regulations.

AMOUNT ENCLOSED:

$_________________

Make check payable to: San Diego Zoo Mail pledge money with the completed pledge collection sheet to: Walk on the Wild Side, P.O. Box 120271, San Diego, CA 92112, or bring with you to the walk. Pledges can be made online at www.sandiegozoo.org/walk Questions? Call 619-557-3939

www.sandiegozoo.org/walk


Walk on the Wild Side Registration Form