An Application
Call Jerry Now At 866-279-4488
 
Free Summer Camp & Program Information
We will forward all summer camp information and recommendations directly to you. All information will be held in confidence.
  *INDICATES REQUIRED FIELD
*Parent/Guardian Name:
*Relationship to Children:
*Address:
*City:
*State:
  Country:
*Zip Code:
*Home Phone: - -
  Work Phone: - -
*Cell Phone: - -
  Best Time to Call :
*E-Mail Address:
*Kind of Camp
*Where would you like the camp to be located
   
   
 
How many children do you need help with: 
 
Child Information
  *INDICATES REQUIRED FIELD
*Child's First Name:
*Child's Last Name:
*Date of Birth: / /
*Age:
*Gender:
*Current Grade:
  Previous Camp Experience:
Please tell us what types of Camps or Programs you are interested in:
I am looking for information on the following camps: (check all that apply)
2 Weeks 4 Weeks 6 Weeks Full Summer
Traditional Sleepaway Camps: (check all that apply)
Co-Ed Brother/Sister Single Sex No Preference
  Specialty Summer Camps & Programs: (check all that apply)
 Academic  Art  Dance  Theatre
 Biking  Music  Remedial  Sailing/Scuba
 Weight Loss  Outdoor Adventure  Filmmaking  Language
 Teen Tours  Pre-College Enrichment  Horseback Riding  Computers
       
Other:
  Sports Camps: (check all that apply)
Baseball Basketball Ice Hockey Soccer
Tennis Golf Lacrosse  
Other: