Parent's first & last name Child's first & last name (if you wish to remain anonymous, omit the above boxes)
Based on you or your child's experience at camp and your personal observations, please complete the following
yes
no
somewhat
Which of the following most influenced your choice of program?
Reputation
Brochure
directors or other staff
Activities
Web Site
References
Location
Camp Visitation
other
uncertain
Additional comments:
Testimonials: (may be used in a future web page or brochures)