Bennett's Place Summer Camp Interest Form
Thank you for your interest in Bennett's Place Learning Center's Summer Camp program. Because we strive for each of our campers have the best experience, we do require that each child and a parent/guardian meet with our program director to ensure that our camp is a good fit for their needs. Due to the large interest in our summer program, we request that you fill out our interest form so that we can efficiently schedule a time to meet. Please allow us 48 hours to respond to your request via phone or email. Thank you for your patience in this process and we look forward to meeting you and your child soon.

*If your child has previously received services at Bennett's Place, this form does NOT need to be completed and you may proceed with filling out the 2019 Summer Camp Registration Form.
Child's First and Last Name *
Child's Age *
Parent 1/Guardian's First and Last Name *
Parent 2/Guardian's First and Last Name
Email *
Phone number *
What is the best method of contact? *
Required
Which days are you and your child available to meet?
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Morning
Afternoon
Evening
Comments/Questions
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