Spring Wildlife Camp 2026 | Quogue Wildlife Refuge

Your Name (Parent/ Guardian)*

First Last

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.

Cell Phone #*

Home/Work Phone #*

Additional Email (Guardian/Parent)

Enter Email Confirm Email

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Child’s Name*

First Last

Child’s Nickname (if applicable)

Nickname

Child’s Age at Time of Camp*

Child’s Grade Level*

Child’s Date of Birth*

Which days will your camper be attending? (select as many as apply)

Tuesday, 4/7

Wednesday, 4/8

Thursday, 4/9

Friday, 4/10

Tuesday, 4/7

Price:

19 camper spots remaining

Wednesday, 4/8

Price:

19 camper spots remaining

Thursday, 4/9

Price:

20 camper spots remaining

Friday, 4/10

Price:

20 camper spots remaining

Four Day Discount!

Price:

Total

Payment Type*

Payment Method*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code

Enter the name on the 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.

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 2026. 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. Quogue Wildlife Refuge reserves the right to use photographs/ videos taken at camps, programs and events for use on our website, publications, and social media.