P RESENTING SPONSOR SPANISH PEAKS HEALTHCARE SYSTEM

SCHEDULE OF EVENTS 9:30 coffee & donuts presented by KKTV (while supplies last) 10:00 Animal presentations / guests may tour the Zoo10:30 Live music by Tom Munch11:30 Lunch

1:00 Bingo

GUEST INFORMATIONWe welcome groups from senior facilities as well as individuals from the public. All seniors ages 65+ will receive free zoo admission all week.

REGISTRATION

Name of Senior Care Facility OR Individual Name*

Name of Facility Activity Director (if applicable)

Phone Number*

Email Address*

# of Senior Individuals Attending*

# guests who will be in wheelchairs

# of Caregivers Attending

LUNCH ORDER

# of pizza slices

Cheese

Sausage

Pepperoni

Check here

SPECIAL NOTES/REQUESTS

Please RSVP by FRIDAY, SEPTEMBER 6 Questions? Call 719-561-1452 Ext 127

My Products

Table$30.00

Table Reservation

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country