Spring Wildlife Camp

Spend Spring Break at the Quogue Wildlife Refuge!

Tuesday through Friday, April 11th – 14th, 2023, 9:00 AM – 12:00 PM

A program for children in grades K – 5th.

Register your child for a great experience of wildlife, education, and fun! Each day will include a hike, a craft, and meeting animals. Please dress your child in warm layers and send an individual snack & drink in reusable containers each day. $280 for the four day program or choose individual dates that work in your schedule.

Please fill out one form per child.

Please call 631-653-4771 with any questions.

Spring Camp Registration 2023

Step 1 of 2

Your Name (Parent/ Guardian)*
First Last
Child's Name*
First Last
Child's Nickname (if applicable)
Nickname
Child's Date of Birth*
Month
Day
Year
Child's Grade Level*

MUST be in grades Kindergarten to 5th Grade
Child's Age at Time of Camp*
Cell Phone #*
Home/Work Phone #*
Email*
Enter Email Confirm Email

All confirmations will be sent to this email address, including any changes in the weeks schedule, or updates on the program. Please use an email that you regularly check and make sure that it is typed correctly.
Additional Email (Guardian/Parent)
Enter Email Confirm Email

All confirmations will be sent to this email address, including any changes in the weeks schedule, or updates on the program. Please use an email that you regularly check and make sure that it is typed correctly.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Registration Options
- All 4 Days - 4/11 to 4/14
- Individual Days
Spring Camp All 4 Days
Price:
Individual days
Price:
Registration Fee - Please Choose individual dates below*
- Tuesday, 4/11
- Wednesday, 4/12
- Thursday, 4/13
- Friday, 4/14
Payment Type*
Enter name on check below.*

Send checks to PO Box 492, Quogue NY 11959 - *Check must be postmarked within one week of this form submission and received before camp begins to ensure your reservation.
Refund Policy*
- I understand and will comply with the Refund Policy below
Refunds will be granted if cancellations are received 2 weeks prior to the start date of the session (minus a $50 processing fee.) There will be no refund if cancellation occurs within two weeks of the first day of the session.
Total
$0.00

Quogue Wildlife Refuge reserves the right to use photographs/ videos taken at programs and events for use on our website, publications, and social media.
Health and Emergency Contact Information
You will be listed as the 1st Emergency Contact. ** PLEASE LIST TWO EMERGENCY CONTACTS IN ADDITION TO YOURSELF.
Emergency Contact Name #1*
First Last
Emergency Contact Phone #*
Relationship to Child*
Emergency Contact #2*
First Last
Emergency Contact Phone #*
Relationship to Child*
*** Please List Your Child’s Medications & Allergies Below****
Any other Medical or Behavioral History (restrictions/limitations, special needs, dietary concerns, etc…):*
1. Parental Consent – Emergency Statement*

This form will be valid for 2023. I hereby grant permission for my child (named above) to attend the Quogue Wildlife Refuge Spring Wildlife Camp and participate in all activities listed. In the event of a medical or weather emergency and/or the inability to contact the designated guardian(s) in such an event, I agree that the Quogue Wildlife Refuge Staff may take such emergency measures, including transportation, as they deem appropriate and shall notify the parent and legal guardian as soon as possible.

Spend Spring Break at the Quogue Wildlife Refuge!

Spring Camp Registration 2023

Step 1 of 2

Quogue Wildlife Refuge reserves the right to use photographs/ videos taken at programs and events for use on our website, publications, and social media.

Health and Emergency Contact Information

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