A.C.O.R.N. Program Request Name * First Name Last Name Corporation (if applicable) Email * Phone * (###) ### #### Program Requested Weekend Camp Session Weekend Overnight Family Getaway Camp Fun Day / Nature Day Design Your Own Activities Requested * Select all that apply. (* Denotes activities available for an additional $10 per individual) Arts & Crafts Archery Ropes Course * Sports Nature Studies Campfire Fishing IEP Goals Meeting Room Horses * Games Swimming (seaonal) * Nature Crafts Performing Arts Dance Outdoor Cooking Living Skills Start Date September - April Only MM DD YYYY End Date September - April Only MM DD YYYY Group Size (if applicable) Comments Thank you for submitting a request for our A.C.O.R.N. Program! You will hear from us shortly.