Donate Life Night at the Zoo registration form

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Become a Donor

About Us
About Donation
Who We Serve
Resources
Charitable Giving
- Champions Gala
- Make a Contribution to Gift of Life Michigan
News
Get Involved

Become a Donor

Register for 2024 Donate Life Night at the Zoo

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Number of guests in your party(Required)

What is your connection to donation and transplantation?(Required)

Select all that apply.

Donor family

Living donor

Transplant recipient

Transplant recipient family

Transplant candidate

Donation and transplantation professional

Advocate for the cause

Other

Celebration of Life Trail

Would you like to honor a loved one with a sign on the Celebration of Life Trail?(Required)

Yes

No

Have you previously submitted a request for a Celebration of Life Trail sign?

Yes

No

Honoree name

Enter name exactly as you would like it to appear on the sign.

Honoree donation affiliation

Deceased donor

Living donor

Transplant recipient

Type of transplant

Honoree photo

Upload a high resolution image of the honoree. Please note that if the file is not large enough, the picture may appear distorted on the sign.

Max. file size: 300 MB.

Photo consent

I acknowledge that I am the owner of this photo and hereby grant permission to Gift of Life Michigan and its designees to print this photo for a Celebration of Life Trail sign which will be on public display at Donate Life Night at the Zoo.

I agree.

You're all set!

If you had a Celebration of Life Trail sign created for a previous Donate Life Day at the Zoo event, we will have the sign on display this year. If you took your sign home after a previous event and would like it displayed this year, you will be responsible for bringing it to the event.

Release of Liability and Photo Waiver

Release of Liability and Photo Waiver(Required)

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN DONATE LIFE NIGHT AT THE ZOO.
(a) I certify that there are no health related reasons or problems which preclude me from participation in this event. The John Ball Zoo and Gift of Life Michigan are not responsible for injury sustained on the premises.
(b) The John Ball Zoo and Gift of Life Michigan shall have no liability of any sort with respect to personal property brought onto the premises.
(c) I understand that at this event I may be photographed. I agree to allow my photo, video, or likeness to be used for any legitimate purpose by the event holders, sponsors, and organizers.

I have read the above information and agree to the release of liability and photo waiver.

Name

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