Wildwood 2016 Registration Form
Register online or by phone with a credit card, or mail this form with payment to:
Wildwood: Mass Audubon
PO Box 826 | Ringe, NH 03461
For personal information protection purposes, fax and e-mail submissions are not accepted.
Camper Information
Please update any information that has changed since last year.
Camper
Last Name: ___________________________________ First Name: _____________________________________________Gender____________
Street Address: ___________________________________ City: ___________________________________ State: ______Zip:________________
Birth Date: _____ /_____ /_____ Age as of June 1: ________ Grade as of Sept 2016: _______________
Person completing this form
Last Name: ___________________________________ First Name: ________________________________ Relationship to Camper:_________________
Phone (Primary): ________________________________ (Secondary): ________________________________
E-mail: ____________________________________________
Address (if different than above): ___________________________________ City: ___________________________ State: ______Zip:_______________
Parent/Guardian (if different than above)
Last Name: ___________________________________ First Name: ________________________________ Relationship to Camper:_________________
Phone (Primary): ________________________________ (Secondary): ________________________________
E-mail: ____________________________________________
Address (if different than above): ___________________________________ City: ___________________________ State: ______Zip:_______________
To register more than one camper, please provide the name, gender, birthdate, and grade of each camper below:
____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
Summer 2016 Schedule and Tuition Information
Register on or before January 15 and pay our 2015 rates!
Check boxes for desired sessions.
Overnight Camp
Cost on or before January 15
Cost after January 15
Dates
Member (Nonmember)
Member (Nonmember)
Session 1
7/3–7/16
$1,865 ($1,965)
$1,925 ($2,025)
Session 2
7/17–7/23
$1,050 ($1,150)
$1,075 ($1,175)
Session 3
7/24–8/6
$1,865 ($1,965)
$1,925 ($2,025)
Session 4
8/7–8/13
$1,050 ($1,150)
$1,075 ($1,175)
Session 5*
8/14–8/20
$1,050 ($1,150)
$1,075 ($1,175)
Session 6*
8/21–8/27
$1,050 ($1,150)
$1,075 ($1,175)
Session 5 & 6*
8/14–8/27
$1,865 ($1,965)
$1,925 ($2,025)

Intersession
Optional, only for campers enrolled in two consecutive sessions. Cost is $130 for members or nonmembers.
*Sessions 5 and 6 individually are available for ages 9-12/grades 4-7 only. Session 5&6 is available to all campers.
Check boxes for desired sessions.
Family Camp

Session 1
Cost on or before January 15
Cost after January 15
Dates
Member (Nonmember)
Member (Nonmember)
6/25–6/28
$265 Adult / $235 Child
($295 Adult / $265 Child)
$270 Adult / $240 Child
($300 Adult / $270 Child)
Add $35 per person for cabin/yurt
Add $35 per person for cabin/yurt
Member (Nonmember)
Member (Nonmember)
$1,640 ($1,740)
$1,675 ($1,775)
Dates
Member (Nonmember)
Member (Nonmember)
Session 2
6/28–7/1
Session 3
8/28–8/31
Please list names and birth dates of additional family camp participants:
Leaders-In-Training*

Dates
Session A
7/3–7/16
Session B
7/17–7/30
Teen Adventure Trips
Acadia Adventure

7/3–7/9
$1,150 ($1,250)
$1,350 ($1,450)
Bike and Beach Trek
7/10–7/16
$1,150 ($1,250)
$1,350 ($1,450)
Footloose in the White Mountains
7/17–7/23
$1,150 ($1,250)
$1,350 ($1,450)
Great North Woods**
7/24–8/6
$2,090 ($2,190)
$2,200 ($2,300)
Exploring the Champlain Valley
8/7–8/13
$1,150 ($1,250)
$1,350 ($1,450)
Backpacking the Wild Whites
8/14–8/20
$1,150 ($1,250)
$1,350 ($1,450)
Caves and Waterfalls in Pioneer Valley
8/21–8/27
$1,150 ($1,250)
$1,350 ($1,450)
*Second Year LITs (Leaders-In-Action, 3 weeks, 8/7–8/27) are accepted by application only; contact us for more information.
**For campers entering grades 10 and up. Previous Wildwood trip experience preferred.
To Register for Camp
Important Deadlines
All camp forms, waivers, and the balance of your camp tuition are due by May
1. If registering after May 1, payment in full is required and a specific camp
form deadline will be set for you. A camper cannot attend camp and his/her
spot is not guaranteed until all forms, waivers, and payments are completed
(or a payment plan has been established).
Visit massaudubon.org/wildwood
Call 866-627-2267 (toll free)
Mail or bring this form and payment to:
Wildwood Camp
P.O. Box 826
27 Vining Road
Rindge, NH 03461
Registraton Confirmation
A confirmation e-mail containing important information will be sent once your
camper’s registration has been processed.
Deposit
The first $50 of each registration is nonrefundable and cannot be transferred
to another camper, family or camp location. If registering after May 1,
payment in full is required (unless a payment plan has been established with
the Camp Director).
Refer a Friend
The best way to enrich our camp community is to welcome your friends. We
will offer a referral bonus to registered camper families for referring new
campers to Wildwood. Contact the office for more information on the referral
bonus.
Financial Aid
Financial assistance is available based on demonstrated economic need and
available funds, and is generally limited to one session per child; however,
all applications are considered. Please call the camp office to request an
application or download one at massaudubon.org/campforms.
Payment Plans
Payment plan options are available. Please contact the camp office for more
information.
Refund Policy
A full refund, minus the nonrefundable deposit, is provided to camp families
who cancel on or before May 15. After May 15 no refund is available. Lost
deposits are not transferable, and refunds are not given for participant
dismissal, failure to attend, absence or sick days. If we must cancel a session,
you will receive a full refund.
Please check one:
Camper Requirements
Due to the outdoor and exploratory nature of our camp program, campers
must be able to move about on uneven terrain. Campers are expected to
meaningfully participate in age-appropriate activities, including nature study.
All campers must follow stated behavior expectations and safety rules, and be
able to complete personal care tasks in an overnight environment. The camp
director reserves the right to dismiss a camper when, in his/her judgement,
the camper’s behavior interferes with the rights of others or the smooth
functioning of the group or activity, or violates the camp’s behavior policy. In
such cases no refunds will be provided. If you have any questions regarding
your child’s ability to participate in our camp program, please contact the
Camp Director.
Camp License
Our camp complies with the regulations of and is licensed annually by the New
Hampshire Department of Environmental Services.
ACA Accreditation
We are proud to be accredited by the American Camp Association. Developed
exclusively for the camp industry, this nationally recognized program
focuses on program quality, and health and safety, management, and camp
operations.
Camp Policy Requests
You may request copies of our background check, healthcare, discipline,
bullying, and grievance policies at any time.
Camp Contact Information
If you have any questions or concerns regarding camp or your child’s
attendance at camp, please contact Camp Director Welch Narron at
603-899-5589 x 3701 or wnarron@massaudubon.org.
Payment Options and Credit Card Authorization
At any time, you may call toll free 866-627-2267 to
obtain your balance or pay with a credit card.
Option 1: Pay total tuition now (required if registering after May 1)
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I have included a check for the total balance.
Please charge my credit card below for the total balance now.
Limited financial aid is available—please call for more
information or to request an application.
Option 2: Installment plan
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I have included a check for 50% of the tuition and will send a check or make a payment online or by phone for 50% of the tuition by May 1.
Please charge my credit card for 50% of the tuition now, and 50% of the tuition on May 1.
Mass Audubon Member: YES / NO Member # (required for discount): __________________________________ Exp. Date: ________________
*To qualify for a camp tuition discount, you must be a current Mass Audubon member at the Family level or above and be the parent, grandparent,
or legal guardian of the camper being enrolled. If you are unsure of your membership status, please call 603-899-5589.
Payment Information: Full tuition payment is required by May 1, 2016
Payment Due Today (At least 50% tuition):
$________
*Mass Audubon Family Membership if Joining/Renewing:
$65
Help make camp a reality for another child! Make a donation to the
Kids to Camp Wildwood Scholarship Fund $250 $100 $50 $25
$________
Total Amount Included:
$________
Payment Method:
� Check included OR � Credit Card (please complete below)
Verification Code:________
Make checks payable to
Wildwood - Mass Audubon
Discover, AmEx, MasterCard, or VISA #: _________________________________________ Exp. Date: _________________________
Signature: _________________________________________________________________
”I agree to allow the Massachusetts Audubon Society to charge my Discover/MasterCard/VISA/AmEx in the amount(s) specified above and understand that refunds will
only be provided in accordance with the refund policy as stated above. I have read and agree to the refund policy outlined in this brochure.”