Skip to content

443-518-7671
attawayprograms@gmail.com

Facebook-f Linkedin Instagram Twitter Youtube

Home
About Us
Our Therapeutic Programming
Events
Help Camp Grow
Job Opportunities
Contact Us

Menu

Home
About Us
Our Therapeutic Programming
Events
Help Camp Grow
Job Opportunities
Contact Us

Pre-Registration Form

Please note: If you are having problems with this form, please try the form again in a different Internet Browser. For example, if you are using Internet Explorer, please try again using Firefox, Chrome, or Safari.

Parent Information

Name(s)*

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Phone:*

Area Code

-

Phone Number

E-mail:

Child Information

Name:*

First

Last

Gender:

Male

Female

Other

Prefer not to say

Child's Date of Birth:

day

/

month

/

year

Grade:

Name of school attending?

Presenting Concerns

Please describe or explain briefly.

Attention Issues:*

Social Issues:*

Compliance Issues:*

Self-Regulation Issues:*

History of Summer Camp Experience AND how did you find out about Camp Attaway?

Follow the directions to confirm you are a real person:

Please note: If you are having problems with this form, please try the form again in a different Internet Browser. For example, if you are using Internet Explorer, please try again using Firefox, Chrome, or Safari.

Camp Attaway

9770 Patuxent Woods Dr.

Suite #303

Columbia, MD 21046

Main Line: 443-518-7671

Fax: 443-518-7672

attawayprograms@gmail.com

2021 Camp Attaway

Like & Follow

Facebook Twitter Instagram Linkedin

Donate via Givebutter

Scroll to Top