🌼nurture with nature🌷farm camp  registration                                                    
🏞 Camp location: 5 abbotts hill road, newtown, ct 06470

👩🏼‍🤝‍🧑🏾Children:  ages 5-12

⏰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 sessions 🥾:
*Sessions will run  Mon-Fri: am & pm sessions.

1️⃣ Session 1:  July 11th-15th:   9 am -12 pm
2️⃣ Session 2:  July 11th-15th:   12:30pm -3:30 pm
3️⃣ Session 3:  Aug 1st-5th:    9 am -12 pm
4️⃣ Session 4:  Aug 1st-5th:       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
-Paypal: PayPal.Me/ndrcounseling
-Check: made payable to ndrcounselingservices.  
              mailing address: 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

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Email *
Child’s  Name:
Child’s  age/grade entering:
Gender/ Preferred Pronouns:
home address
Camp session(s) signing up for:                                
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
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🌼 See you soon at the farm, friends! 🐐🐖🐑🐔🐈🐕
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