Fields marked with an * are required
Important Notice: We recommend that you use the latest version of the Google Chrome or Mozilla Firefox browsers when filling out this application. If you submit this form and the submission appears to be unsuccessful, please contact us by emailing email@example.com, or calling us at 313.962.8242.
Camp Dates for 2017 are:
Session One: Saturday, June 24 - Sunday, July 2
Session Two: Wednesday, July 5 - Thursday, July 13
Session Three: Sunday, July 16 - Monday, July 24
Session Four: Thursday, July 27 - Friday, August 4
Campers may attend a maximum of two sessions with one session break in between.
Please fill out all fields before submitting your application!
We are unable to grant requests for late arrival or early pick-up times. Please choose a session where your child can be in attendance at camp for the entire nine days.
*Applications must be submitted no later than 3 weeks before session begins.**
**** Please note that we are not equipped to accept children who require one-on-one care. ****
Please indicate the following (associated problem)
All medications must be in the original container with the child’s name and dosage amount. We can not deviate from these directions.
Please send the exact amount of medication needed for the entire session.
Activities of Daily Living
Personal Care Information
The above information is true and accurate to the best of my knowledge.
I understand that Camp Grace Bentley is not equipped to service children who require one-on-one care or are unable to function on a 3-1 camper/counselor ratio.
Upon submitting application to Camp Grace Bentley please note:
Application to Camp Grace Bentley does not insure that your child will be accepted. A committee will review the application to determine if Camp Grace Bentley is equipped to accommodate the needs of your child. Many factors are taken into consideration.
The decision of the committee is final.
After submission of the online application you will be asked to download two additional forms which must be signed and mailed to:
Camp Grace Bentley
c/o Nancy Perri-Mitchell
Birmingham, MI 48009
Camper Physical Record which must be signed by a licensed physician
Release agreement which must be signed by the parent or guardian.