Week Long Camps Schedule and Registration

An afternoon snack is provided in all of our programs.

Note: Exceptions can be made for siblings in different grades to attend on the same day for all After School programs.

All events are located at: Chintimini Wildlife Center Education Yurt, 311 NW Lewisburg Rd, Corvallis. See map and directions.

 
Contact Ronda at youth@chintiminiwildlife.org or 541-609-8990 for information.
 
Register and Pay Online

Child's Name 1: Child's Age 1:
Child's Name 2: Child's Age 2:
Child's Name 3: Child's Age 3:
Child's Name 4: Child's Age 4:
Parent/Guardian Name:
Address 1:
Address 2:
City:
State/Province:
ZIP/postal code:
E-mail address:
Work Phone
(with area code):
Home Phone
(with area code):
Cell Phone
(with area code):
Emergency Contact & Phone:
For Spring Break Camp participants, please indicate Number of Tshirts in appropriate sizes:
Adult
Small
Adult
Medium
Adult
Large
Youth
Small
Youth
Medium
Youth
Large
Spring Break Camp - Week long Camp
Spring Break Nature
Immersion Camp
March 27-31, 2017
$200 - Ages 5 and up
March 27-31, 2017, 9am - 4pm
Children need to bring lunch; we provide a snack and a t-shirt.
Call 541-609-8990 or email Ronda to arrange (optional) pre/post child care, $5 an hour per child

Total Fees
$0.00
Write down this amount!
Payment Method
Submit this form. Follow instructions for either method.
Paypal    By check
Allergies/Medical Information/Additional Information (on campers):
Authorized By (Represents your signature):
I give CWC permission to include my child in photographs that may be used in brochures, newsletters and other media. Yes    No

By submitting this application, I hereby certify that I am the legal parent or guardian of the child. I understand and assume the risks of participation in this program. For myself, my heirs, and assigns, I agree to waive, release, and forever discharge any claim for injury or damage, and hold harmless Chintimini Wildlife Center (CWC), its officers, agents, volunteers, and employees against any claim, loss, liability, or expense, including attorney's fees, resulting directly/indirectly from participation. I also give CWC permission to use photographs of participant(s) in marketing and media brochures, newsletters, and website.

Pay online by credit card through PayPal after you Submit this form (or you can mail us a personal check).