Next Generation Farm Camp Enrollment
Please complete the form below for Next Generation summer camp. Camp dates:__July 25th- July 29th _
Camper Last Name *
Your answer
Camper First Name *
Your answer
Camper Age (during camp) *
Parent Name(s) *
Your answer
Parent Address, City *
Your answer
Parent Phone (xxx) xxx-xxxx *
Your answer
Parent 2 or Emergency Contact Name *
Your answer
Parent 2 or Emergency Contact Phone (xxx) xxx-xxxx *
Your answer
Camp runs M-F from 9:30am-3pm at COM Indian Valley College. Will your camper need extended care (3-4:30pm) for an additional fee? *
Please note any camper special needs or "none". *
Your answer
To complete your enrollment, please submit payment to Next Generation for $290. Add $100 for extended care.
Go to: and click on the "DONATE" button. Be sure to write your CAMPER NAME in the "Purpose" field. Or, send a check to Next Generation, 636 Lindaro St., Suite 100, San Rafael, CA 94901. Your space is not confirmed until payment is received.
Payment status: *
Thank you!
Please submit your form when you are done.
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