Please fill out one registration form per family. 

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* 1. Participant Information #1

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* 2. Participant Information #2 (leave blank if not applicable)

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* 3. Participant Information #3 (leave blank if not applicable)

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* 4. Participant Information #4 (leave blank if not applicable)

If you have more than four participants in your family please contact the Quinipet Office by email; quinipetprogram@nyac.com or by phone; (631) 749-0430

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* 5. Emergency Contact Information (Please notify this person)

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* 6. The Spring Into Action Workday is planned to run from 8am-4pm. If you plan on arriving or leaving at alternate hours please indicate what times you plan to attend. (i.e. 9am-4pm)

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* 7. Do any of the above participants have any special skills or areas of interest that they're interested in contributing to our Service Weekend? If so, please list. Ex: Gardening, painting, etc.

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* 8. Do any of the above participants have any medical needs or concerns we should be made aware of? If yes, please explain.

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* 9. What is your connection to Quinipet?

Food Services
  • A cheese pizza lunch will be provided to participants by Quinipet.
TERMS & CONDITIONS
  • I hereby enroll myself and/or my family members listed above with The New York Conference of The United Methodist Church Spring Into Action volunteer workday and agree to the following terms and conditions:
  • All information supplied in this camper registration form is correct.
  • I recognize the risks associated with camp and the volunteer workday, and do not hold The New York Conference of The United Methodist Church responsible or legally liable unless losses and/or injury results directly from the negligent or willful act of staff acting within the scope of their responsibilities.
  • Quinipet adheres to all New York State Guidelines regarding COVID-19. I understand that I may be required to wear a mask/facial covering at all times while on camp and adhere to social distancing requirements.
  • I give permission and consent for me and my family to allow photographs and videos to be taken during the volunteer workday activities. I further give permission and consent that any such photographs and videos may be published and used by The New York Conference of The United Methodist Church and its agents, to illustrate and promote the camp experience and/or camp programs.

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* 10. I have read and understand the terms and conditions as outlined above.

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