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FOrt Wayne Climate Camp: June 29, 9:30am-3pm

Registration Form: Applications Due by June 3, 2019

Vera Dulin Wildlife Observation Building at Fox Island Allen County Park. Children Ages 7-12 may Apply.

Climate Camp is $20 per student. Upon acceptance, you will be given payment instructions at that time. Thank you for registering!

Camper Name *
Camper Name
Parent/Parents' Name(s) *
Parent/Parents' Name(s)
Address *
Address
Phone *
Phone
Are you able to receive text messages at this number? *
Camper Birth Date: *
Camper Birth Date:
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 Earth Charter Indiana. *