2021 Summer Camp Application
Henry's Place Summer Camp is free for children who would not otherwise have a chance to go to camp and who are from low-income families, high-crime neighborhoods, and/or families where one or both parents are absent.  THIS APPLICATION MUST BE COMPLETED BY THE APPLICANT'S PARENT OR LEGAL GUARDIAN.  A representative from Henry's Place will contact you to confirm that you have been accepted for camp.

If you have any questions or problems with this application, please contact the Camp Director, Corey, 562-457-7021 or CampDirector@HenrysPlace.org. To learn more about Henry's Place, please visit www.HenrysPlace.org.

What About COVID-19 (coronavirus)?  Henry's Place is absolutely committed to the well-being of our campers and staff.  We will continue to plan for our 2021 Summer Camps.  Not later than July 1, we will decide whether to continue or cancel our camps, based on the latest guidance and information regarding COVID-19.  If we do conduct camp, we will do so with enhanced screening, hygiene, and disinfection processes in place. 

YOU CANNOT SAVE PROGRESS IN THIS FORM.  To complete this application, you will need personal information for the camper, parent/legal guardian, and primary contact (if other than parent/legal guardian), medical information (including date of last tetanus shot), and medical insurance information.  If you find you are lacking any information as you fill out this application, complete the application all the way to the end, submit it, and then save the "Edit Response" link (provided after submittal) so that you can come back and fill in what you missed.

Sign in to Google to save your progress. Learn more
Camper's Information
Camper's First Name *
Camper's Last Name *
Camper's Grade as of May 1, 2020 (Applicants should be in 6th or 7th grade) *
Camper's Birthday *
MM
/
DD
/
YYYY
Camper's Email (if you have one)
Gender and Camp Dates *
Camper's Shirt Size *
Camper's Home Address (Street, City, State, ZIP) *
Camper's Phone (if applicable)
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Henry's Place. Report Abuse