Camper's Name *

First Name

Last Name

Second Camper's Name

First Name

Last Name

Parent / Guardian Name *

First Name

Last Name

Parent / Guardian Phone (mobile preferred) *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Camp week(s) *

Week 1: July 1-5 Beach Naturalists (SOUTHOLD) Waitlist

Week 2: July 8-12 Estuary Explorations (SOUTHOLD) Waitlist

Week 3: July 15-19 Birds of Prey (MATTITUCK)

Week 4: July 22-26 Wild Canines (MATTITUCK)

Week 5: July 29-Aug 2 Wilderness Survival (CUTCHOGUE)

Week 6: August 5-9 Turtles All the Way Down (CUTCHOGUE)

Week 7: August 12-16 The Buzz About Pollinators (CUTCHOGUE)

Week 8: August 19-23 Wilderness Survival (CUTCHOGUE) waitlist

T-shirt Size *

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult XL