AV Eagle Convocation Wilderness Program Registration Form
Due March 31
Student Name
First Name
Last Name
Student ID #
Grade
Ethnicity: White, Black, Asian, Hispanic, Other
Student Email
example@example.com
Student Cell # (if you have one)
Please enter a valid phone number.
Format: (000) 000-0000.
School:
AVHS
SES
Current grade:
9
10
11
Parent Name
First Name
Last Name
Parent Email
example@example.com
Parent Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Choose one of the two options below:
I need a Science credit-recovery credit and would like to earn this while on the trip.
I would like to earn an elective Science credit by completing the Summer Science Institute course while on this trip.
Choose payment options that fits your situation:
I am a 1st time camper and can pay the full price
I am a 1st-time camper and would like to apply for a camp scholarship. I qualify for the Federal REDUCED Lunch program as evidence of need. I am committed to completing the program and coursework if provided with this support. Note: we keep this request and support confidential. The cost will be reduced to $375.00. We have limited camp scholarships. We can offer up to some larger camp scholarships for students with a greater need. Contact Ms. Grande if you need to request this larger camp scholarship. Do not let a lack of funds stop you from going!
I am a 1st-time camper and would like to apply for a camp scholarship. I qualify for the Federal FREE lunch program as evidence of need. I am committed to completing the program and coursework with this support. Note: we keep this request confidential. The cost will be reduced to $175.00. We have limited camper scholarships. We can offer up to some larger camp scholarships for students with a greater need. Contact Ms. Grande if you need to request this larger camp scholarship. Do not let a lack of funds stop you from going!
I am a 1st-time camper and would like to apply for a camp scholarship to bring the cost down. I do not qualify for the Free & Reduced Lunch program as evidence of need but I have a financial need that I can share privately. I am committed to completing the program and coursework if provided with this support. Note: we keep this request and support private. Contact Ms. Grande in the main office if you need this help.
Student shirt size
Please Select
XXL
XL
L
M
S
XS
STUDENT - By signing this form, you are committed to completing this program:
Parent -By signing this form, you are committed to helping ensure your child completes this program:
I need to borrow a sleeping bag from the camp or AVHS staff. We encourage you to try and find one to borrow as we have a limited number we can loan to students.
Yes
No
I need to borrow a raincoat/rain pants from the camp or AVHS staff. We encourage you to try and find one to borrow as we have a limited number we can loan to students.
Yes
No
If you need to borrow a raincoat/rain pants from the camp what size do you need?
XXL
XL
L
M
S
XS
Submit
Should be Empty: