Camper Application

Fields marked with an * are required

Camper Application

 

If you do not receive a success message when you hit submit then we did not receive the application! Please check that all required fields are filled and resubmit.

Camp Dates for 2022 are:
Session One: Saturday, June 25 - Sunday, July 3
Session Two: Wednesday, July 6 - Thursday, July 14
Session Three: Sunday, July 17 - Monday, July 25
Session Four: Thursday, July 28 - Friday, August 5

Campers may attend a maximum of two sessions with one session break in between.

All campers are required to be vaccinated for COVID-19 and must wear masks or face shields during indoor activities.

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)

General Health:

Medications:
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.

Skin care

Special Equipment

Activities of Daily Living

Personal Care Information

Adjustment to Camp

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.

The cost per session is $750.  The first $50 (for each session) of the camp fee must be paid before the camper's spot will be held.  This $50 is nonrefundable, but is applied towards the $750 cost per session.  Parents may pay this fee online when submitting the application.  If it is not paid when submitting the application, it must be paid after receiving the acceptance letter or submit a letter from the organization that will pay for the entire session fee before the camper's spot will be reserved.

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 Anthony DeWolfe
1321 Concord Place Dr
Kalamazoo, MI 49009

Camper Physical Record which must be signed by a licensed physician

Release agreement which must be signed by the parent or guardian.

If you do not receive a success message when you hit submit then we did not receive the application! Please check that all required fields are filled and resubmit.