Counselors At Home
Please fill out this form to request a Counselors at Home booking or let us know more about your family's needs.
In order to complete a booking you will need the dates and times you'll need care, contact information for all parents/guardians as well as additional emergency contacts, names and ages of all children, location details (address, house rules, pets, parking etc), as well as health and safety information for all attendees.
If you're interested but need to partner with another family, we may also be able to introduce you to others who are looking to form a Pod.
If you just need more information before you can commit, we can help with that too.
After you submit this form, our local team will be in touch within one business day. Thanks!
Parent / Guardian First and Last Name
Parent / Guardian Email Address
Parent / Guardian Phone Number
Preferred Contact Method - Please ensure you've provided correct information for your preferred method
Where do you live?
This allows us to know how we can best partner with you based on Counselor's service areas
New York City
San Francisco & North Bay
SF: East Bay
SF: South Bay & Peninsula
Virginia, Maryland & DC
How can we help you?
I'm ready to book directly
I'd like someone to contact me and help me book
Help me find a POD before booking
I have some questions
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This form was created inside of Steve & Kate's Camp.