Financial Assistance Form

FINANCIAL ASSISTANCE FORM

* Indicates required field

Name of Parent/Guardian *

First

Last

Email *

Phone Number *

Please list names, ages, and current grades of all children planning to attend camp: *

Please list names and ages of everyone in household who is NOT attending camp (including children and adults): *

Please list annual household income from all sources: *

Please select amount of Financial Assistance requested: *

$25/camper (Adventure Day) $50/camper (Weekend or Mission Camp) $75/camper (Weekend or Mission Camp) $100/camper (Weekend or Mission Camp) Please contact me with other options

SIGNATURE (please type full name). The above information is complete and accurate. I understand that funds are limited and Financial Asistance may not be available. I understand that, if awarded Financial Assistance, I am responsible for full payment of the balance of camp fees above the amount of assistance. *

Submit