SPRING BREAK CAMP 2026

Seed Song Farm and Center Spring Break Camp

Registration Form 2026

STOP! To successfully complete this form, you must provide an electronic copy of your childs immunization records.

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Monday March 30th - Friday April 3rd, 2026

Additional Day Program: Monday April 6th

9am to 3pm with before and after-care available
Ages 4 & up

*One form is required for each registrant. You may utilize the auto-fill feature when filling out forms for multiple children.

*If you plan to request payment plan or financial assistance, please fill out this form and wait for approval. You will need a unique promo code to complete this form.

Name of Child*

First NameLast Name
Date of Birth (Month/Date/Year)*

MonthDayYear
Age of Child (Child must be 4 years old on or before camp start date)
Gender Child Identifies With: (check box that applies)*

MaleFemalePrefer not to sayOther
Child's Preferred Pronouns (He, She, They)

Emergency Contact Information: Please indicate 1-2 individuals other than yourself who can act as an emergency contact between the hours of 9 am and 3 pm
Name of Emergency Contact 1 *

First NameLast Name
Phone Number of Emergency Contact 1*
Emergency Contact 2 Name

First NameLast Name
Emergency Contact 2 Phone Number
Please enter a valid phone number.

PART B: Immunization & Medical Information
Please provide a copy of the child's immunization history by submiting electronically below. This form is required for registration.

Subpart 7-2 of the New York State Sanitary Code requires camps to maintain immunization records for all campers which includes dates for all immunizations against diphtheria, haemophilus influenza type b, hepatitis b, measles, mumps, rubella, poliomyelitis, tetanus and varicella (chickenpox The record must be kept on file for every camper and updated annually.
Please Upload Immunization Records here *

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Medical/Dietary/Behavioral Information:

Please include any information you would like us to know about your child, including attaching a copy of any applicable treatment plans or IEP.
Medical Information: (Including Allergies)
Dietary Information: (Including Food/Ingredient Allergies)
Behavioral Information
IEP or Treatment Plan Included with Submission:

YesNo
Upload IEP or Treatment Plan here

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Would you like to discuss your child's specific needs with a Camp Director prior to Camp Start Date? (check box that applies)

YesNo

Part C: Cancellation/Refund Policy, Photo Release & Newsletter Information

Cancellation Policy

In the event of a public health outbreak, we are unable to give any refunds.

All Registrations Are Final: Once your registration is submitted, it is considered final. No refunds, cancellations, or transfers will be granted unless discussed with the director.
Photo Release Policy
"I permit Seed Song Center to take photos, videos and sound clips of my child and my child's projects at camp and to use them at its discretion."
Signing here attests that you agree to our Cancellation Policy, Photo Release Policy, and being subscribed to our semi-weekly Newsletter*

PART D: Payment

Spring Break Camp 2026 is $400 per week.
How did you hear about our summer camp program? (Check boxes that apply)*

Child has participated in past camp sessionsHudson Valley ParentChronogramFacebookInstagramSeed Song NewsletterWord of mouthOther
Registration fees are due in full. If you are unable to pay in full, please don't let this deter you from registering.

Cash or Check Payment:

If you prefer to pay by check or cash, please email camp@seedsongfarm.org for a unique code to enter at check out.

Financial Assistance & Payment Plans

If you are requesting financial assistance or a payment plan, please do not submit payment at this time. Complete the request form and wait for approval. You will receive a promo code to complete registration if approved.

Seed Song Programs are committed to being accessible to all. Financial assistance is available on a limited, case-by-case basis for families experiencing significant financial hardship. We ask that this option be requested only when the full program fee would create a genuine financial burden.

Please fill out a financial assistance request form at SeedSongFarm.org prior to submitting this form. You will not be able to submit this form until the financial assistance form is processed by staff.

My Products*

Spring Break Camp

$400.00

DAY program- Monday, April 6th, 2026

$80.00 Quantity

Donation to Seed Song Center

Donate to the Low Income & Under-served Camper Fund

$ Free Amount

Enter coupon

Total

$0.00

Accessibility for All! An essential part of our mission is to make healthy farm experiences available to all, to make a tax-deductible donation please choose an amount above.
To pay with Venmo: click on the Paypal option to find the Venmo button.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.