Request Information About Summer Overnight and Sleepaway Camps

Please complete the form below and a CampSource representative will call you. Remember to indicate the best time to call.

Note: We never share info with any third parties without your permission.
* = Required Field

Form completed by:	*

Child will be attending summer of:

How did you hear about us?	*

Name of person who referred you:

Which CampSource consultant were you referred to?	*

Parents’ Information:
Parent 1 Full Name:	*
Parent 2 Full Name:
Address:	*
City:	*
State:
Postal Code:	*
Country:	*
Daytime Phone:	*
Evening Phone:
Best Time and Number to Call:	*
Parent Email Address:	*

Child’s Information:
Child’s Name:	*
Date of Birth:	*
Current Age:	*
Current School Grade:	*
Name of School:
Gender:	*

Additional Siblings:
Sibling 1 Name:
Sibling 1 Birthday:
Sibling 2 Name:
Sibling 2 Birthday:

Child’s Personality
Competitive Non-Competitive Outgoing Shy

Child's Interests (check all that apply):
Archery Arts and Crafts Baseball Basketball Camping Canoeing Climbing wall Equestrian Field Hockey Football Golf Gymnastics Hiking Ice Hockey Kayaking Lacrosse Music/Band Outdoor Adventure Photography Ropes Roller Hockey Soccer Swimming Sailing Tennis Theatre/Dance Volleyball Wakeboarding Waterskiing Windsurfing
Other Interests:

1st Overnight Experience?

Previous Summer Experience:


Camp Information:

Type of Camp Desired: (Check all that apply)
All Boys Camp All Girls Camp Coed Camp Brother/Sister Camp Traditional Camp Sports Camp Arts Camp
Other type of camp:

Location Preference:
Desired budget per week:
Length of Stay:
Size of Camp:
Religious Affiliation:

More Information:

Is your child planning to attend a summer program with a friend? If yes:
Friend's Name:
Friend's Phone Number:
Friend's Email:

Medical Info: Does your child have any medical conditions(s) that we should be discussing with the director?


Any Special Needs?

Anything else about your child that will help us fill their needs:


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