Please complete this short form to be entered to win one (1) Zoo New York Pack Pass, which includes free access to the zoo all year long. The membership is valid for 365 days and provides admission for up to five people (adults or children).

Children and youth qualify if they:

• Are ages birth to 21

• Have or are suspected of having a chronic physical, developmental, behavioral, or emotional condition

• Require extra health and related services beyond what children generally need.

Conditions include but are not limited to ADD or ADHD, allergies, anxiety, arthritis/joint problems, asthma, autism or autism spectrum disorder, behavioral/conduct problem, blood disorders, Cerebral Palsy, Cystic Fibrosis, depression, developmental delay, diabetes, Down syndrome, epilepsy/seizure disorder, genetic or inherited condition, head injury, hearing problem, heart problem, intellectual disability, learning difficulty, migraines, other mental health condition, muscular dystrophy, sickle cell anemia, speech or language disorder, substance use disorder, Tourette syndrome, and vision problem. The program is not limited to these conditions.