🌼nurture with nature🌷farm camp registration

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Welcome new & old friends!!

This will be our 2nd summer of farm camp and we are 'goat' to have so much F-U-N!!!

🏞 Camp location: 5 abbotts hill road, newtown, ct 06470

👩🏼‍🤝‍🧑🏾Children: recommended ages 5-12 (let’s chat to see if your child is a good fit outside this age range)

⏰3 hr daily sessions

💲Cost per session is $300 per child, paid at time of registration.
(Sibling & multiple session discounts available. Please let us know at time of signing up)

🏕️Camp scholarship & sponsorship opportunities available- pls inquire🥾2023 Camp sessions 🥾:

*Sessions will run Mon-Fri: am & pm options

1️⃣ Session 1: July 10-14 : 9 am -12 pm

2️⃣ Session 2: July 10-14 : 12:30pm -3:30 pm

3️⃣ Session 3: July 31- Aug 4: 9 am -12 pm

4️⃣ Session 4: July 31-Aug 4 : 12:30pm -3:30 pm

5️⃣ Session 5: Aug 7-11: 9 am-12pm

6️⃣Session 6: Aug 7-11: 12:30pm -3:30 pm

🧴Parents/guardians: please apply sunscreen before coming to camp

🧃🥨Each child should bring water & a small nut-free snack

👟Each child should bring a towel, wear comfortable clothing & closed toed shoes/sneakers.

💲Payment options:

-Venmo: @Naomi-DaPazRibeiro (pls put in subject line: child’s initials & date of class)

-Paypal: PayPal.Me/ndrcounseling (pls select for family & friends to avoid processing fees)

-Check: made payable to: ndrcounselingservices

5 abbotts hill road, newtown, Ct 06470.

-Cash- please arrange with me personally

🌼nurture with nature (newtown):
by Naomi DaPaz Ribeiro, LCSW
email: nurturewithnaturenewtown@gmail.com
Fb: nurture with nature-newtown
Telephone: (203) 491-0802
website: abbottshillfarm.com

Email *

Child’s Name:

Child’s age/grade entering:

Gender/ Preferred Pronouns:

home address

2023 Camp session(s) signing up for:

1️⃣ Session 1: July 10-14 : 9 am -12 pm

2️⃣ Session 2: July 10-14 : 12:30pm -3:30 pm

3️⃣ Session 3: July 31- Aug 4: 9 am -12 pm

4️⃣ Session 4: July 31-Aug 4 : 12:30pm -3:30 pm

5️⃣ Session 5: Aug 7-11: 9 am-12pm

6️⃣Session 6: Aug 7-11: 12:30pm -3:30 pm

Parent/Guardian Name:

Cell Phone:

Email:

Emergency Contact:

Emergency Contact Phone Number:

Authorized adult(s) to pick up camper (relationship & tel number)

(2nd) Authorized adult(s) to pick up camper (relationship & tel number)

Allergies:

Does your child have any medical, physical, or emotional conditions ? Yes ( please explain):

Preferred hospital in case of emergency:

Primary Doctor & tel number:

Does your child have an IEP or 504 plan during the school year? If so, this information would be helpful in programming and individualizing your child’s needs with us. (a copy of your child’s 504 plan or IEP plan would be beneficial if you can attach):

What is a hope or goal you have for your child at our camp? What would you like your child to learn more about? (feelings, coping skills, friendship, emotional regulation, connecting with nature, interacting/being comfortable around animals, social problem solving skills, etc?):

Tell us about your child’s strengths. What are they good at (socially, emotionally, academically, family, friendships etc):

What is something you would like us to know about your child:

Any additional info you would like to provide:

*I have signed the camp waiver form & have emailed a copy to nurturewithnaturenewtown@gmail.com (waiver form found in link below)

https://docs.google.com/document/d/1jkfE8BmdeDkuLxkpZWyNJkWEIO1rIXEvpklIAiFHJgY/edit?usp=sharing

Camp payment method

venmo

paypal

check

cash

Clear selection

How did you hear about us?

facebook

instagram

friend, neighbor etc

local newspaper

nextdoor app

Clear selection

🌼 See you soon at the farm, friends! 🐐🐖🐑🐔🐈🐕

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