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Summer Programs Parent Survey
Please fill out this form completely. Items in
bold
are required.
Parent's First Name
Parent's Last Name
City of Residence
Email
Camper's Name
Based on your expected summer schedule, please rate from 1 - 4 which camp you are MOST (1) to LEAST (4) interested in.
1
2
3
4
Sleep Away Camp 1 week
Sleep Away Camp 1 weekend
Day Camp 1 month
Day Camp 1 week
No Camp
Please select how much you anticipate paying:
Select One
$200 - $400
$500 - $700
$800 - $1000
$1100 - $1200
If you check "No Camp" for 2010 for any reason (won't go, can't pay) please share why
If you checked "Day Camp" please indicate how many miles you would be willing to drive:
Select One
5 miles
10 miles
20 miles
30 miles
More than 30 miles
The camp focuses on the arts, as it has been in the years past - primarily film. For 2009 we successfully included animation, journalism, modeling, magic, and music. We would like to continue offering a unique camp that focuses on creativity.
Please check which workshop themes interest you for your child....
Animation
Acting/Film
Dance
Documentary/Film
Journalism/Newspaper
Magic
Modeling
Photography
Painting
Music
At camp we have also included other activities. Please check which of these activities you would like to see included for your child at camp this year.
Arts and Crafts
Camping
Cooking/Baking
Hiking
Sports
Swimming
Travel
Video Games
Other
Other
We are open to your support and the support of the community.
Do you know someone or an organization (merchants, companies, talent) that would possibly like to:
Contribute financial support to camp
Name or organization
Contact # or email
Additional Information
Donate some supplies to camp
Name or organization
Contact # or email
Additional Information
Volunteer their talents
Name or organization
Contact # or email
Additional Information
Give their talents for a discounted rate
Name or organization
Contact # or email
Additional Information
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F.A.C.T. Focus on All Child Therapies (310) 475-9620
Support for Autism Spectrum Disorder and Aspergers in Los Angeles County and Orange County, California
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