Climate Camp 2019 Registration

To Register for 2019 Climate Camp, Please complete the form below. We will process your application and send you a link to complete payment, If the Application is Accepted.

CLOSED:::Week 1, New Climate Warriors: July 8-12, 2019: Ages 5-17

Week 2, Returning All Stars: July 15-19, 2019: Ages 7-17

Climate Camp hours are 9am-4pm.

The Camp fee is $100 per student.

Camper Name *
Camper Name
Address *
Address
Phone *
Phone
Are you able to receive text messages at this number? *
Camper Birth Date *
Camper Birth Date
Applying for: *
You must obtain advanced permission to apply for Week 2, please contact jimpoyser@earthcharterindiana.org for more information
Shirt Size *
Camper receives free or reduced lunch at school: *
(We are required by our funders to report the % of campers who qualify for the free &/or reduced lunch program.)
I am applying for a financial grant to cover the $100 camp fee. *
Emergency Contact Phone Number *
Emergency Contact Phone Number
I give my child permission to participate in all phases of the 2019 Climate Camp. In an emergency, when neither I nor the emergency contact person named can be reached, I hereby authorize the camp director to take any action deemed necessary for the best interests of my child. I also give permission for photos and videos taken of my child at camp to be used for public relations purposes for Peace Learning Center, HEART, and Earth Charter. *