Fun Fact: In the Victorian language of flowers, the Hyacinth flower symbolizes sport or play.

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Eco Explorers Summer Camp Registration Form

Parent/Guardian Contact Info

Name

Address

City

State

Zip Code

Preferred Phone #

Additional Phone #
(If no phone, enter NA)

E-mail

Camper Information

Last Name

First Name

Birth Date (MM/DD/YYYY):

Age as of first day of camp:

Camper phone number:
(If no phone, enter NA)

How did you hear about camp?

Enrollment Selection

Select Session:

Session I (July 7- July 17) (Ages 8-9)
Session II (August 4 – August 14) (Ages 10-11)
Session III (August 18 – August 28) (Ages 12-13)

Medical and liability forms will be sent to you via email after your registration in received. Please complete and send back as soon as possible.

Acknowledgement of Terms

Parent or Guardian - Your signature below indicates compliance with summer camp regulations. After submitting your registration, someone from the Ecology Connection will contact you to discuss payment options.

Parent/Guardian Signature

Date

Prospect Park Brooklyn, NY

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