Registration

Camp Dates (Adventure Week Option available in all but Week #1)

Week #1 (May 29 – June 2, Outdoors Adventure Week)

Week #2 (June 5 – 9, Variety Pack)

Week #3 (June 12 – 16, Scavenger Hunt)

Week #4 (June 19 – 23, Relay)

Week #5 (June 26 – June 30, The Republic of Field Camp)

Week #6 (July 3 – July 7, Elijahball)

Week #7 (July 10 – July 14, Blue Ridge Pool and Moormans River Fest)

Week #8 (July 17 – July 21, Andy Goldsworthy)

Week #9 (July 24 – 28, Film Fest)

Week #10 (July 31 – August 4, Hogs/Frogs)

Week #11 (August 7 – August 11, Pirates Week)

Week #12 (August 14 – August 18, Holidays)

Adventure Week Program (for Ages 11-14) Dates (more details on the About page)

Adventure Week #1 (June 5-9) Paddling program

Adventure Week #2 (June 12-16) Paddling program

Adventure Week #3 (June 19-23) Climbing program

Adventure Week #4 (June 26-June 30) Hiking program

Adventure Week #5 (July 3-7) Climbing program

Adventure Week #6 (July 10-14) Paddling program

Adventure Week #7 (July 17-21) Paddling program

Adventure Week #8 (July 24-28) Climbing program

Adventure Week #9 (July 31-August 4) Hiking program

Adventure Week #10 (August 7-11) Hiking program

Adventure Week #11 (August 14-18) Variety Week

The weekly fees (which includes everything such as the annual tee shirt, daily lunches, shuttle rides, overnights and overnight meals) are $600/week for 1-2 weeks, $550/week for 3-4 weeks, and $500/week for 5+ weeks.  A $25 per week discount is provided for all registrations prior to April 15th.  You can hold spaces for the summer by making a $500 deposit (the deposit will be credited toward the last week’s fee).  The Adventure Weeks have the same fees with an additional $100/week.  

Cancellation and Change Policy:   We have flexibility about changing weeks of attendance prior to April 15th and as long as weeks are not full.  After April 15th, however, we often cannot honor change requests.   In the event of a family’s change of plans after April 15th, partial refunds will be made up to 2 weeks prior to planned attendance. If requesting more than 4 weeks prior to attendance, a fee of $100 will apply per week cancelled, and in the event of refund requests between 2 and 4 weeks prior to attendance, a $300 fee per week will apply. We do not maintain formal wait lists (our experience has been that families generally make alternative plans rather than utilizing wait lists), though we do our best to accommodate all families.

Parent/Guardian Information

Parent Name *

First

Last

Parent #2 Name

First

Last

Address

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Is your family new to Field Camp this summer?

• Yes
• No, we have been here before.

Email *

Email #2 (if needed)

Phone #1 *

Phone #2

Emergency Contact #1

Name *

First

Last

Phone

Emergency Contact #2

Name

First

Last

Phone

Camper #1 Information

Name of First Camper *

First

Last

Name of School and Grade Attended Prior to Camp

Date of BirthMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Medical Concerns, Allergies, or Food Issues

Please describe your child's swimming ability:

Camper #2 Information

Name of Second Camper

First

Last

Name of School and Grade Attended Prior to Camp

Date of Birth (copy)MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Medical Concerns, Allergies, or Food Issues

Please describe your child's swimming ability:

Camper #3 Information

Name of Third Camper

First

Last

Name of School and Grade Attended Prior to Camp

Date of Birth MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Medical Concerns, Allergies, or Food Issues

Please describe your child's swimming ability:

We provide a free daily shuttle to and from Charlottesville. The shuttle bus operates from the front parking lot at Azalea Park (304 Old Lynchburg Road) in Charlottesville, picking up Mondays, Tuesdays, Wednesdays and Thursdays from 8:15 through 8:30, and dropping off on Mondays, Tuesdays, Wednesdays and Fridays from 4:15 to 4:30.

• We will use the shuttle daily.
• We will use the shuttle occasionally.
• We will not use the shuttle.

Dates of Attendance

• Field Camp, May 29 - June 2
• Field Camp, June 5 - 9
• Adventure Camp (Ages 11+), June 5 - 9
• Field Camp, June 12-16
• Adventure Camp (Ages 11+), June 12-16
• Field Camp, June 19 - 23
• Adventure Camp (Ages 11+), June 19 - 23
• Field Camp, June 26 - 30
• Adventure Camp (Ages 11+), June 26 - 30
• Field Camp, July 3 - 7
• Adventure Camp (Ages 11+), July 3 - 7
• Field Camp, July 10 - 14
• Adventure Camp (Ages 11+), July 10 - 14
• Field Camp, July 17 - 21
• Adventure Camp (Ages 11+), July 17 - 21
• Field Camp, July 24 - 28
• Adventure Camp (Ages 11+), July 24 - 28
• Field Camp, July 31 - August 4
• Adventure Camp (Ages 11+), July 31 - August 4
• Field Camp, August 7 - 11
• Adventure Camp (Ages 11+), August 7 - 11
• Field Camp, August 14 - 18
• Adventure Camp (Ages 11+), August 14 - 18

My child has permission to travel in camp-approved transportation and to participate in all activities, including swimming. I authorize the camp to provide or consent to emergency medical care or treatment of my child. I agree to pick up an ill child when notified. I understand that camp involves risks, and I agree not to hold Field Camp liable for injuries sustained during camp or charges incurred in medical treatments, whether covered by our insurance or not. I authorize the camp to use pictures of my child in promotional literature. I understand that I am responsible for payment of camp fees, that these are due in full by the Monday of each week of attendance, and that payment is required regardless if the child attends. Deposits are non-refundable, non-transferable, and will be applied to the last week of camp attendance. I acknowledge these policies and understand that this is a legal and binding agreement.

Signature *

Clear Signature

Deposit

• Deposit for One Camper - $ 575.00
• Deposit for Two or More Campers - $ 1,000.00

Stripe Credit Card *

Card

Name on Card

Do you have a payment code?SelectYes

Code

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