Camp-I-Can Registration Form
Thank you for your interest in the CoStars Camp-I-Can Program. The program is designed for children Kindergarten eligible to 6th grade (*Roberts ONLY is also open to children in 7th-8th grade). Please take a few minutes to complete this form so we can learn more about you, your specific needs and interest in our program.
Demographics
Child's Name
*
First Name
Last Name
Child's Date of Birth (DOB)
*
-
Month
-
Day
Year
Date
Sex Assigned at Birth
*
Male
Female
Child's Gender Identity
Male
Female
Non-Binary/Non-Conforming
Transgender
Other
Prefer not to respond
Which location for Camp I Can will your child be attending?
*
Please Select
Madisonville Campus (June 2nd-August 6th 7:30 am-5:30 pm)
Westwood Campus (May 28th-August 8th 7:00 am - 6 pm)
Oyler School (June 2nd-June 27th 9:00 am-5:00 pm)
Roberts Academy (June 2nd-June 27th 9:00am-5:00 pm)
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
Parent/Guardian Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Has your child previously attended or is currently working with another program provided by Best Point Education and Behavioral Health?
*
Please Select
Counseling
Day Treatment
Camp I Can
Before or After School
No
Is your child currently attending Before or After School programing at Oyler, Roberts Academy or Westwood?
Please Select
No longer attending
Yes - Westwood
Yes - Oyler
Yes - Roberts Academy
Payment Method ($235 a week)
*
Please Select
Self Pay
Using Active Childcare Voucher
Applying/Applied for Childcare Voucher
Thank you for completing your Camp-I-Can referral form!
Best Point Intake department will follow up once receiving your submission for Camp-I-Can to answer any questions you may have and talk about next steps.
Submit
Should be Empty: