Summer Camp Sign Up

Please complete the below. You will receive a follow up email confirming acceptance into camp with follow up payment details (please do NOT pay any deposits unless you receive a text from Captain Justen directly with deposit details - 617-223-7201). We will also follow up with a Fishing Waiver & Release Form that needs to be s

Legal Guardian Name

First Name

Last Name

Phone

(###)

###

####

What week would you like to sign up for?

July 14-18th (7-11 year olds)

August 4-8th (11-15 year olds - Extended Week)

August 11-15th (7-13 year old - all ages)

How many children?

Child #1 Name

First Name

Last Name

Child #1 BirthDate

YYYY

Child #2 Name

First Name

Last Name

Child #2 BirthDate

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name, Relationship & Phone Number

Please include someone who will be available during camp hours, feel free to include a second emergency contact.

Please list all allergies & medications, please note if child will be coming to camp in possession of the medication.

For those with any allergies, special health care needs, or disabilities we will put together Individual Care of Plan & Authorization for the Administration of Medication form for the child before camp starts.

Shirt Sizes (for Life Jacket purposes)

Summer Camp Sign Up

Location: