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) *

(###)

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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Camp week(s) *

Week 1: July 1-5 "Life Between the Tides" WAITLIST

Week 2: July 8-12 "Seashore Explorations" WAITLIST

Week 3: July 15-19 “Birds of a Feather” WAITLIST

Week 4: July 22-26 "Mammals of Long Island" CUTCHOGUE

Week 5: July 29-Aug 2 "Wilderness Explorations" CUTCHOGUE

Week 6: August 5-9 "Turtles and Friends" CUTCHOGUE

Week 7: August 12-16 "Pollinators" CUTCHOGUE

Will your child attend after care? *

Please select an option that best suits your family's needs. Please contact us for rates.

Yes, every day (until 3:00 PM)

No, we will pick up at 2:00 PM

Every now and again (per diem) on non-specific days

On scheduled days (e.g. Tues & Thurs)

We are unsure at this time

T-shirt Size *

Youth XS

Youth Small

Youth Medium

Youth Large

Youth XL