Donation Form
Thank you for your generosity to Camp Assurance!
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
I would like to receive regular updates from Camp Assurance
Yes, please
Phone Number
*
Donation Category
Please Select
General Fund
Camper Scholarship Fund
Resident Staff Support (please specify)
Summer Staff Scholarship - all
Summer Staff Scholarship- specific summer staff member (please specifiy)
Needs List Items
Upcoming Projects
Notes
Please specify any designations or SAFE Fund recipients.
Donation Amount
prev
next
( X )
USD
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Submit
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