Camps and Summer Programs Directory Form

Contact Information

Please note that this section is for internal records only.

Company Name*

Contact/Title*

Full Address*

Please include city, state and zip code.

Phone Number*

Email*

Frequency & Schedule

Select the months you would like to run your directory advertisement.

Campaign Schedule*

February
March
April
May
June

Directory Text

The information you put in this section below will be placed in the magazine as you complete it. If you leave a field blank, it will not be listed, so we recommend that you use all fields available to your advantage.

Category*

You must select ONE category. Selecting multiple categories will result in additional directory purchases.

Basic Category

Please select all that apply. Note that this section will appear on website only.

Dates of Camp

Business/Camp Name*

Full Address

Please include city, state and zip code.

Contact/Title

Phone Number

Email

Website*

50 Word Description*

Longer entries will be edited at the Editor's discretion. Do not repeat information that is already listed in other areas of your directory listing.

Payment Details

Paying Via*

Please select from list below. If you are prepaying via credit card, please continue with the Credit Card Submission Form below (note that you will need to hit the "Submit" button here and then again when you are ready to submit your final directory form.

Please send electronic invoice.
Check
Credit Card

Receipt Required

If you need a receipt, please list the e-mail address of the individual to be e-mailed a PDF receipt of purchase.

Terms and Conditions

I fully understand that this advertising contract is subject to the schedule and payment amount set forth above to be prepaid in full or prior to publication. The liability of the publisher for any error or omission for which it may be held legally responsible shall in no way exceed the cost of the space paid for and occupied by such advertisement. Oral agreements are non-binding. Cancellations must be submitted in writing by the first of the month prior to the scheduled advertisement. I have the authority to execute this contract and take full financial responsibility for the total amount incurred (including but not limited to collection fees, past due charges, production fees, if applicable) on behalf of the above named company and authorize Midwest Parenting Publications, LLC to publish advertising as noted above.

Advertising Representative*

For internal records, we need to know the advertising representative from SW Ohio Parent with whom you are working.

Your Signature of Agreement and Today's Date*

I agree to all terms and conditions listed above and within this contract with this digital signature. (Please type name in the field above).

Please review all information before you click "Submit." Once you click this button your information will be sent. Please wait for the confirmation screen once you have clicked "Submit." If you do not click "Submit" your information will not be received by our office.