Camp Registration Form 2026 – Capen Hill Nature Sanctuary

2026 Capen Hill Camper Registration

"*" indicates required fields

Camper Information

** one camper per form **

Child's Name*

First Last

Age at the start of Camp*

Years

Months

Please list as whole numbers.

Grade in September

Contact Information

Parent 1

First Last

Parent 2

First Last

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Cell Phone Number*

For general contact purposes if needed

Work Phone Number

Another back up number if needed

Contact Email Address*

Enter Email Confirm Email

Emergency Contact 1*

First Last

Relationship to Camper 1*

Emergency Phone Number 1*

Emergency Contact 2

First Last

Emergency Contact Number 2

Relationship to Camper 2

Medical Information

Medical History

To help us understand your child’s individual needs, tell us any medical information that we should be aware of such as peanut or bee sting allergies, nosebleeds, headaches, etc. Please provide any suggestions / restrictions per doctor’s order.

Before your child starts camp, we need a copy of their immunization record.
If you can’t upload now (below), you can upload via a link on our website at a later date.
If your campers appointment is after the start of camp, please provide their last record.

File

Max. file size: 256 MB.

Please upload a copy of your child’s immunization record. These are required by the local Board of Health to run camp.

Medication*

Does your child need medication at camp? If yes, we will provide a form upon check-in on their first day.

Name of Medication

Epipen*

Does your child need to have an Epipen at camp? If yes, we will provide a form upon check-in on their first day.

Doctor's Name*

First Last

Doctor's Phone Number*

Sessions

2026 Prices

$275 a Session

*** Multi Session (3+) Discount ***

$250 a Session (per camper)

discount will automatically be applied

Quantity

How many sessions will your Camper be attending?

Please select which session(s) your Camper will be attending.

Sessions

Session 1 July 6-10

Session 2 July 13-17

Session 3 July 20-24

Session 4 July 27-31

Capen Hill Apparel

T-Shirt

Price: $20.00

Yellow Tee with Capen Hill logo

T-Shirt Size

Please select T-Shirt size

Visor

Price: $15.00

OSFA Tan Visor with Capen Hill logo

Additional Information

Group/Friend Placement – Pick-up/Drop-off Info

If you would like your child to be placed with friends or siblings of a similar age, please write information pertaining to this in the box. If camper(s) is being picked up by anyone other than parents, please write that here as well. If we have a question, we will contact you.

Parental Permission Waiver*

I Accept

I Don’t Accept

I hereby authorize the staff of Capen Hill Nature Sanctuary to act for me in accordance with their best judgement in any emergency requiring medical attention. I understand that the director of the camp may, if necessary for my child’s health, have him/her hospitalized or use outside medical, surgical or dental care. I hereby waive and release Capen Hill Nature Sanctuary for expenses incurred due to sick illness or accidental injury sustained while participating in camp activities. I also understand that the director and/or camp leaders may dismiss my child from Capen Hill Nature Camp, if, in their opinion his/her conduct or influence is not in the best interest of the entire group. No refund is given if such action is taken for discipline reasons.

Payment

How would you like to pay?

Total Payment:

Payment Method