Massachusetts Family Program
We are excited about the upcoming Comfort Zone Camp family program on Saturday, December 7th at Tantasqua Regional High School from 9:30 am – 4:00 pm! Please complete the questionnaire below. Here are some instructions:

• This questionnaire is to be completed by the parent/guardian. The child should NOT be included in its completion.
• It must be completed in one sitting and cannot be saved once it has started.
• A new form must be filled out for each child.
• If we need to follow up, we will contact you via email

Please note that childcare can be provided for children between the ages of 2-7 years old (must be potty trained). Be aware that this is a long day and younger children may benefit from not attending. We cannot provide childcare for children under 2 years of age.

If you have questions, please contact Kim or Callee, by email or by phone: (804) 377-3430. We look forward to serving your family this year!
Email address *
Parent/Guardian Name *
Your answer
Home Address *
Your answer
Relationship to Camper(s): *
If Legal Guardian - Other, please describe:
Your answer
Parent/Guardian Cell Phone Number *
Your answer
How did you hear about Comfort Zone? *
Your answer
T-Shirt Size *
Your answer
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