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Request Brochure, DVD and Information

The KenMont and KenWood Office will be closed for vacation starting
Monday, September 6th and will re-open in Miami on Monday, September 13th.
We will process your request for information upon our return.


Please provide the following information. (
* denotes a required field )
You must enter information for at least one parent.

2011 Camp Dates

1st Session: Wednesday, June 29 - Sunday, July 24

2nd Session: Wednesday, July 27 - Sunday, August 21


Year Interested In*
Session Interested In*
Parent 1
Parent 2
Relationship*
Relationship
Title*
Title
First Name*
First Name
Last Name*
Last Name
Home Phone*
Home Phone
Work Phone
Work Phone
Cell Phone
Cell Phone
E-mail*
E-mail
 
Mailing and Contact Information
Send Mailing to (Name)*
Address*
City*
State*
Zip*
Country
 
Potential Camper Information
(please complete for each child)
1st Camper
2nd Camper
First Name*
First Name
Last Name*
Last Name
Gender*


Gender

Grade entering Sept. 2010*
Grade entering Sept. 2010
School*
School
Previous Camping
Experience*
Previous Camping
Experience
     
3rd Camper
4th Camper
First Name
First Name
Last Name
Last Name
Gender

Gender

Grade entering Sept. 2010
Grade entering Sept. 2010
School
School
Previous Camping
Experience
Previous Camping
Experience
 
How did you hear about us?

         Please Specify Name*

 
Please let us know your child's interests and any special notes
you would like to share with our Directors
 
This Request was filled out by*
 
                  




 

 

 

 


 

 

 

 

 

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