Camp Wayne for Boys
Request Information
Inquiry Form
Please provide the following information. (
*
) denotes a required field
Additionally, you must enter a name and e-mail address for at least one parent.
Parent 1
Parent 2
Relationship
Mother
Father
Stepmother
Stepfather
Aunt
Uncle
Grandmother
Grandfather
Legal Guardian (F)
Legal Guardian (M)
Foster Parent (F)
Foster Parent (M)
Partner (F)
Partner (M)
Other (F)
Other (M)
Relationship
Mother
Father
Stepmother
Stepfather
Aunt
Uncle
Grandmother
Grandfather
Legal Guardian (F)
Legal Guardian (M)
Foster Parent (F)
Foster Parent (M)
Partner (F)
Partner (M)
Other (F)
Other (M)
First Name
First Name
Last Name
Last Name
Work Phone
Work Phone
Cell Phone
Cell Phone
E-mail
E-mail
Family Contact Information
Country
(if not US)
Address
Line 1
*
Home Phone
*
Address
Line 2
Best time
to reach you
City
*
How did you
hear about us?
ACA - Rene Flax
ACA-Robin Katz
Camp Chemistry - Don Richner
Camp Connection - Barries
Camp Connection - Okin
Camp Connection - Ronni Bergman
Camp Experts - Beth Goldstein
Camp Experts - Debbie Alfonso
Camp Experts - Joanne Paltrowitz
Camp Experts - Lisa Borg
Camp Experts - Lynne Marks
Camp Experts - Marla Leader
Camp Experts - Nadja Streiter
Camp Experts - Risa Goldberg
Camp Experts - Robin Berman
Camp Experts - Shari Bernstein
Camp Finder - Rick Mades
Camp Source-Abbe Shapiro
Camp Source-Harriet Conn
Camp Spec - Arlene Streisand
Other Agent:
SCATA - Janice Millman
Student Summer - Sue Ellen Greenberg
Student Summers - Jody Schwartz
Student Summers - Paltrowitz
Student Summers - Patti Roberts
Student Summers - Susan Kasnett
Student Tour - Ann Travis
Student Tour - Judy Macnow
Summer Camp - Ellen Wylie
Summer Sol - Jill Tipograph
Tips on Trips
Tips on Trips - Ann Fuchs
Tips on Trips - Carey Rivers
Tips on Trips - Eve Eifler
Tips on Trips - Helaine Isaacs
Tips on Trips-Lisa Mullen
Alumni
Family/Friend
Google
Internet Other:
Yahoo
Other
Camp Name:
Camp Wayne for Girls
Camp Wayne for Girls
Lake Bryn Mawr Camp
Neighbor
WOM Other:
*
Please specify
*
State
Alabama
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Armed Forces Pacific
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Ontario
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Quebec
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Yukon
*
Zip
*
Whom should
we contact?
No Preference
Mother
Father
Child 1
Child 2
First Name
*
First Name
Last Name
*
Last Name
Date of Birth
*
Date of Birth
Grade
Select
Pre-Pre-K
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
12th+
(Sept. 2009 )
*
Grade
Select
Pre-Pre-K
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
12th+
(Sept. 2009 )
School
School
Season
Interested In
2010
2011
2012
2013
2014
Season
Interested In
2010
2011
2012
2013
2014
Previous
Camp Experience
Previous
Camp Experience
Interests
Interests
Brief Description
of your child
Brief Description
of your child
Children's privacy is of primary concern to us, and our Policy and practices reflect applicable laws and regulations on children's privacy. We do not knowingly collect personal information from children under 18 years of age. Any communication we get that is identified as being from a child under 18 will be immediately removed from our database. All information gathered from our camp families is used exclusively for camp, and no third-party vendors. We urge parents to regularly monitor and supervise their children's on-line activities.
Privacy Policy
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