Campership Application 2021

Campership Application 2021
Complete the form below and submit it following your camp registration. We will do everything we can to campership info to parents by May 1st.
First Name *
Last Name *
Date of Birth *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/ Guardian *
Parent is a Summer Roundup Volunteer

Yes No
Day Phone *

Area Code Phone Number
Evening Phone *

Area Code Phone Number
Cell Phone *

Area Code Phone Number
Primary Email for receiving camp forms: *
example@example.com
Amount family can pay: *
Amount requested: *
Number of people in household: *
Yearly Income: *
Reason for financial assistance request: *
The family's needs and the availability of Council funds determine the amount granted. All information is kept confidential.
For questions regarding camping, paying, or volunteering, call Amy Schisler at 410-725-1693 or email summerroundup@gmail.com
Should be Empty:

The family's needs and the availability of Council funds determine the amount granted. All information is kept confidential.