When

Monday, July 22, 2019 at 9:00 PM EDT
-to-
Friday, July 26, 2019 at 3:00 PM EDT

Add to Calendar

Where

Blithewold Mansion, Gardens & Arboretum

101 Ferry Road
Bristol, RI 02809

Event Address Map
Driving Directions

Contact

Jillian Cleveland - Registrar
Blithewold Mansion, Gardens & Arboretum
401-253-2707 x 15
jcleveland@blithewold.org

Life in the Sea (July 22 – 26)

Thank you for your interest in Camp Sequoia! Please fill in all the boxes below. This form not only signs you up for camp but also provides important health and care information for you child.

* Required information

Parent or Guardian Information

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  • Blithewold Camp Sequoia Authorization Statement: “This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed camp activities except as noted. I hereby give permission to the medical personnel selected by the camp director to act in the best interest of my child in the case of an emergency. Every effort will be made to contact a responsible adult. I also give permission for routine first aid care by the camp staff and grants permission for the staff to give the medical provider the name and policy number of the medical insurer. I also give permission for the use of pictures, video, and statements by the campers in Blithewold promotional materials.”

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    Please click below to agree to the above Blithewold Camp Sequoia authorization statement.

  • Promo Code

    Apply
  • Fee

    Type Fee
    $240.00
    $190.00

Camper Information and Health History

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  • Health History (Please check all the apply)

  • “This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed camp activities except as noted. I hereby give permission to the medical personnel selected by the camp director to act in the best interest of my child in the case of an emergency. Every effort will be made to contact a responsible adult. I also give permission for routine first aid care by the camp staff and grants permission for the staff to give the medical provider the name and policy number of the medical insurer. I also give permission for the use of pictures, video, and statements by the campers in Blithewold promotional materials.”

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Additional Camper Information and Health History

You may add a maximum of 5

Camp Pickup Authorization (List of people authorized to pick up your camper)

  • For the safety of your child(ren), they may be picked up from camp ONLY by those individuals specified by you in writing on this authorization release form. All authorized persons must show a picture ID or some type of valid identification, which will be requested by Blithewold camp staff. In emergencies, a telephone call authorization may be acceptable. In some cases, we will call a number you have given us previously to verify that it is you making the call.

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$9,999.99

Payment

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