Capen Hill Science and Nature Camp Registration Form 2022

2022 Capen Hill Science and Nature Camp Registration Form

  • YearsMonthsGrade in September 
    Please list as whole numbers.
  • Please include your e-mail address. Thank You
  • Before your child starts camp, we need a copy of his/her immunization record. Form may be mailed to Capen Hill Nature Sanctuary, P.O. Box 218, Charlton City, MA 01508 or emailed to You may also upload immunization record below.
  • Max. file size: 2 MB.
    Please upload a copy of your child's immunization record if you have not sent it in. Thanks
  • Price: $200.00
  • Price: $15.00
  • Price: $12.00
    One size fits all.
  • If you would like your child to be placed with friends or siblings of same approximate age, please write information pertaining to this in the box. It helps us out now then to try to place friends together when groups are already designated. If we have a question, we also will contact you. Thanks for your cooperation.
    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.
  • $0.00
  • Choice One is Paypal or Credit Card. Credit card payment is under the Paypal Login. Choice 2 is Send a Check