Girl with Toad

Spring Break Camp 2024

The Spring Break Camp at Heckrodt Wetland Reserve is designed for children 1st thru 6th grade to learn about their natural environment through hands-on interactive activities.

During this program, wizards will enjoy nature-related activities and crafts. They will discover the magical creatures and plants who call Heckrodt home and create potions that engage the mind.

Step 1:
Fill out this registration and authorization form below:

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

General Information

Child's First Name*

Child's Last Name*

Child's Age*

Grade Level*

Parent/Guardian Name*

Address*

Street Address City State ZIP Code

Phone*

Email*

How did you hear about this day camp?

Emergency Contact

Emergency Contact #1 — Full Name*

Relationship to Child*

Contact #1 Phone*

Emergency Contact #2 — Full Name*

Relationship to Child*

Contact #2 Phone*

Insurance Company*

Policy Number*

Hospital Preference*

Doctor*

Doctor's Phone*

My child has the following allergies or medical needs*

If no allergies or medical needs, please indicate N/A or None

Medications my child is currently taking*

If sending medication(s) to camp, please give name of medication and dosage instructions. If no medications are currently taken, please indicate N/A or None

Signature

In order to register you must read the Terms and Conditions linked below:

Day Camp Terms and Conditions

Parent/Guardian Signature*

Date*

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Please be sure to pay for the same session that you registered your child for. Payment must be received in order for your child to be considered registered.

There will be a $15 non-refundable processing fee in the event you must cancel. You may receive a refund minus the $15 processing fee if cancellations are made ten business days before session begins.

Step 2:
Pay here:

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