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Camp Questionaire

Basic Information
Your Name:
Your Telephone Number:
Your Email:
Name of Camp:
Camp Address
Address 1:
Address 2:
P.O. Box/Apt.:
City:
State:
Zip Code:
If there is more than one location, please include a list of additional locations.
Anticipated Camp Start Date:
Anticipated Camp Closing Date:
How many weeks will the Camp be in operation?:
Estimated Number of Campers Per Week:
Is the Camp a Day or Resident Camp?:
Day Resident
Is the Camp an Educational or Sports Camp?:
Educational Sports
Did the Camp have an accident insurance plan last season:
Yes No
If you answer to the preceding questions was YES, please provide the name of the insurance company, a schedule of coverages, benefits and limits, and the premium and claims paid for the past three camp seasons. This additional information can be forwarded to our office by either fax or e-mail for the most prompt response, or by regular mail.

If the camp involves sports, please list them here. Sport, Estimated Campers per Sport and Per week, Age range of Campers

Enter Security Code as shown below: