AYA@USC Family Zootopia - December 2, 2023
Dear Friends, welcome to our upcoming AYA@USC Family Zoo Day on Saturday, December 2, 2023, 10 am - 5 pm. Please kindly RSVP by August 10, so that we can better serve you and also connect on the day of the event. Limited number of tickets are available. First come, first serve. These tickets are reserved for AYA cancer patients/survivors (ages 18-39) and their kids. Up to 4 tickets are allowed to RSVP per family.

For questions, please email shuli@usc.edu. Thank you!

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Los Angeles Zoo
Your Name *
Email Address *
Phone Number *
Are you
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Please let us know where you are/were treated for cancer. *
Required
How old were you when you were diagnosed with cancer? *
What was your cancer diagnosis? *
Where are you from? Please provide us with your city, state and zip code. *
How did you hear about this event? *
How many zoo tickets do you need for you and your family members? We are currently providing up to 4 tickets per family. If you need more than 4 tickets, we can add you to our waiting list. *
What are the names of your guests and their ages?
Do you have any food allergies?
Do you need any special accommodations?
Why would you like to join this event? *
Why do you think it is important to have an AYA program? *
Would you like to join our email newsletter so that you can be updated on our upcoming news & events? *
Thank you again for joining our AYA@USC community and this special retreat to be connected with other AYAs. If you have any question, please contact shuli@usc.edu or visit aya.usc.edu.
A copy of your responses will be emailed to the address you provided.
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