EmailMe Form - Accessible Customer Feedback Form

Start date of your visit with Countryside Camp. *

MM / DD / YYYY HH : MM AM/PM

Did we respond to your customer service needs? *

Yes

No (please explain below)

Was our customer service provided to you in an accessible manner? *

Yes

Somewhat

No (please explain below)

Details of your customer service experience:

If you wish to be contacted by Countryside Camp, please provide your information?

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Personal information contained on this form is collected pursuant to Ontario Regulation 429/07, the Accessibility Standards for Customer Service and will be used for the purpose of responding to your request. We appreciate your feedback.