Day Camp Registration Form

Cape Fear Botanical Garden Day Camp Registration Form - ALL CAMPS ARE CURRENTLY FULL

Day camps are from 9 am - 3 pm on select dates. A themed snack is provided during camp and campers should bring a lunch. The cost of camp is $20 for members and $30 for non-members.
My child is registered to participate in this program offered by the Cape Fear Botanical Garden (CFBG). I'm fully aware and assume all the risks and hazards incidental to the conduct of activity and do further hereby release, absolve, and indemnify and hold harmless the CFBG, its employees, the organizers, the instructors, the sponsors and supervisors, any or all of them. I acknowledge that I have had the opportunity to obtain information about such risks and hazards. (Please type your name here).*
I hereby grant permission to CFBG to use my photograph(s) in any print or web materials. I acknowledge the right of Cape Fear Botanical Garden to crop and format the photographs as necessary. I hereby agree to release and hold harmless CFBG, from and against any claims, damages or liability arising from or related to the use of photograph(s). I recognize that photo credit will be given at the placement of photograph(s) when possible. If the person is under 18, I certify that I am his/her parent or legal guardian and I give my consent without reservation to the foregoing on his/her behalf. (Please 'Yes' if permission is granted).*

YesNo
EDUCATION MASK REQUIREMENTS

Cape Fear Botanical Garden follows mask guidance from Federal, County, and State health officials. In accordance with County Schools, starting March 1st masks will be strongly encouraged, but not required during Cape Fear Botanical Garden programs. By signing I acknowledge my understanding of this policy and acknowledge that this policy could change before the program date according to official guidance and case numbers. If required, I agree that I or my child will follow the mask mandate for the future program or camp. Should you have any questions, please contact our Education Manager Barbara Goldentyer at 910-486-0221, ext. 43 or email: bgoldentyer@capefearbg.org .
I have read and agree to CFBG's Education Mask Requirement policy. (Please type your name below).*
Select Camp Session(s) (Child MUST be the minimum age listed on Garden website. No exceptions)*
Parent/Guardian Name*
Parent/Guardian E-mail*
Camper Name*
Camper DOB*
Camper Age as of the first day of camp session*
Address (include city and zip)*
Home Phone
Cell Phone*
Work Phone
Second Parent/Guardian Name*
Home Phone
Cell Phone*
Work Phone
Emergency Contact in case the above cannot be reached:*
Home Phone
Cell Phone*
Work Phone
Relationship to Camper*
In addition to those listed above, I give authorization for the following adult(s) to pick my child up from camp:
Campers will only be realeased to the adults listed on this form. Photo ID may be requested at the time of pick up. Please be aware of this policy.
Does your child have any known allergies (foods, medications, plants, animals)? Please list:
Please list any medications being taken by your child. This information is needed in case of a medical emergency. Please be advised that Cape Fear Botanical Garden does not administer or store any type of prescription or non-prescription medication.
May camp staff apply a sunscreen lotion or spray (SPF 50) on your child?*

YesNo
May camp staff apply insect repellent (7% DEET) on your child?*

YesNo
Is there anything else you would like the staff to know about your child or your child's health?
Is there any information you would like CFBG staff to know prior to attending this program? Does your child(ren) have any special needs or physical restrictions? List these or any other notes for the Education Department here.
This health information is correct and complete as far as I know. The camper named is in general good health and I give permission for him/her to participate in all camp activities unless otherwise noted. (Please type your name here).*
In case of accident or illness, I authorize a representative of the CFBG to obtain immediate medical care for my child as deemed necessary by a licensed medical personnel. In case of injury, I hereby waive all claims against the CFBG, its' employees, the organizers, the instructors, the sponsors and the supervisors. (Please type your name here).*
Please Select:*
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Non-Member Camp Fee$30.00
The $30 non-member camp fee is per child and per camp. Please ensure you are selecting the correct amount if you have more than one child participating in this camp or if you are registering for more than one camp.

Quantity

Garden Member Camp Fee$20.00
The $20 member camp fee is per child and per camp. Please ensure you are selecting the correct amount if you have more than one child participating in this camp or if you are registering for more than one camp.

Quantity

Total $0.00
(Optional): How did you hear about CFBG Camps?
(Optional) I would like to sign up to receive the CFBG Education newsletter via email.
Garden Member Number:
Full payment is due at the time of registration. Maximum 15 children per camp. Each camp has at least two dedicated Garden staff. Membership discount applies at Household Membership level to include children.

Refunds
To withdraw from a camp, you must provide a written request one week before the start of camp. If the withdrawal request is received one week prior, a refund will be given minus a $15 administrative fee per child per camp. No fees will be refunded if registration is canceled after the week prior deadline.

Wait List
A wait list will be started if camp sessions fill up. If space opens in your desired camp session, you will be contacted and given the opportunity to accept or decline the space. Upon accepting the space, registration fees and forms will be due to secure your camper's spot. Please contact our Education Manager Barbara Goldentyer at 910-486-0221, ext. 43 or email: bgoldentyer@capefearbg.org if you wish to be added to a waitlist.
Payment will be submitted via PayPal. Hitting submit will direct you to the PayPal site, and will complete your registration process.
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Cape Fear Botanical Garden Day Camp Registration Form - ALL CAMPS ARE CURRENTLY FULL