Junior Keeper Program Booking Form | Ballarat Wildlife Park

"*" indicates required fields

X/Twitter

This field is for validation purposes and should be left unchanged.

Junior Keeper Details

First Name*

Last Name*

Age*

Emergency Contact Name*

Emergency Contact Phone Number*

Address*

Street Address Suburb State Post Code

Date Booked Into Program*

Additional Details

Allergies (Please specify)

Medical Conditions (Please specify)

Medications

Special Requirements

Other Information

Consent*

I am the legal Parent or Guardian of the above child, and I give my child permission to participate in the Junior Keeper Program. I understand that they will be interacting with animals and handling food.

Photo Consent

I am the legal Parent or Guardian of the above child, and I give permission for the Ballarat Wildlife Park to use photos taken during the Junior Keeper program in potential advertising material including social media.

Leave box unticked if you do not wish photos of your child to be taken/used.

Junior Keeper Booking Form

Junior Keeper Details

Additional Details

Julie Muir

Deep Patel

Ricky Chan

Julio Najera

Sanoj

Farhan Khan

Ballarat Wildlife Park

250 Fussell Street
Ballarat East, 3350
Victoria, Australia

Opening Hours

Monday - Sunday
9:00am to 5:00pm

Closed Christmas Day

Follow us on

Awards

Best Major Attraction

Best Attraction

Junior Keeper Details

Additional Details

Julie Muir

Deep Patel

Ricky Chan

Julio Najera

Sanoj

Farhan Khan

Main Menu

More Information