Camp Registration Form

Camper's Name*

First Last

Camp Sessions*

If attending multiple sessions, please select all sessions your camper will be attending. Sessions not listed are FULL, please call the office to be put on the Wait List.

Session 1; June 3-7 for ages 3 & 4 yrs
Session 3; June 24-28 for ages 6 to 10 yrs
Session 4; July 1-3 for ages 5-12 yrs
Session 5; July 8-12 for ages 5 to 12 yrs
Session 6; July 15-19 for ages 5 to 12 yrs
Session 8; July 29-August 2 for ages 4 to 6 yrs
Session 9; August 5-9 for ages 3 & 4 yrs

Age of Child on the First Day of Camp*

T-Shirt Size (shirt included with registration)

Name of Parent / Guardian*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone (cell)*

Phone (home)

Phone (work)

Name of First Emergency Contact (in case the parent / guardian listed above is not available)*

First Emergency Contact Phone Number*

Name of Second Emergency Contact (in case the parent / guardian listed above is not available)

Second Emergency Contact Phone Number

Is this a returning or first-time camper?*

Returning
First-Time

Is another family member attending camp?

Yes
No

If yes, who?

Please list a name(s) of registered campers your camper wants to be with.

Note:
Camp Teams/Groups will be divided by age group; youngest, middle, and oldest (as we had done pre-covid summers)

How did you hear about Dahlem's Outdoor Adventure Day Camp? (Check all that apply)

Returning Camper
Social Media (Facebook, Instagram, etc.)
Email Notice from Dahlem
Dahlem's Website
Advertisement/Flyer
Referral
Other

Please list name(s) of registered campers your camper wants to be with:

Referred By:

Are You a Dahlem Member?*

Yes
No

Become a Member?*

Yes
No

Membership Type

Camp Session 1 - Member*

Price:

Camp Session 1 – Member*

Price:

Camp Session 2 - Member*

Price:

Camp Session 2 - Member*

Price:

Camp Session 3 - Member*

Price:

Camp Session 3 - Member*

Price:

Camp Session 4 - Member*

Price:

Camp Session 4 - Member*

Price:

Camp Session 5 - Member*

Price:

Camp Session 5 - Member*

Price:

Camp Session 6 - Member*

Price:

Camp Session 6 - Member*

Price:

Camp Session 7 - Member*

Price:

Camp Session 7 - Member*

Price:

Camp Session 8 - Member*

Price:

Camp Session 8 - Member*

Price:

Camp Session 9 - Member*

Price:

Camp Session 9 - Member*

Price:

Camp Session 1 - Non-Member*

Price:

Camp Session 2 - Non-Member*

Price:

Camp Session 3 - Non-Member*

Price:

Camp Session 4 - Non-Member*

Price:

Camp Session 5 - Non-Member*

Price:

Camp Session 6 - Non-Member*

Price:

Camp Session 7 - Non-Member*

Price:

Camp Session 8 - Non-Member*

Price:

Camp Session 9 - Non-Member*

Price:

Refund Policy:
Refunds (less a $35 administration fee per session cancelled) will only be provided if cancellations are received one week (7 days) minimum prior to the selected camp week.

Photograph Release:
By submitting this form, I grant The Dahlem Conservancy permission to display photo(s) or video(s) of my child on posters, brochures, displays, and any other audio-visual media representing The Dahlem Conservancy and/or its programs. Displays may be in-house, at community events, broadcasts, in newspapers, or any other audio, visual media.

Total

$0.00

Payment Method*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Camp Registration Form

Contact Dahlem

Visit Dahlem