Summer Camp Scholarship 2023

Our Scholarship program reduces the weekly fee of $100 down to $50 per week. Includes snack & lunch, and 2 field trips a week!! Monday-Thursday • 9am-1pm • July 17th-August 24th • Ages 7-12. Fill out the form to apply for this scholarship.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade*
Name of School*
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
MEDICAL INFORMATION
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical Concerns
My Products
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1 Week Summer Camp Payment$50.00

2 Week Summer Camp Payment $100.00

5 Week Summer Camp FULL Payment$250.00

Total $0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Our Scholarship program reduces the weekly fee of $100 down to $50 per week. Includes snack & lunch, and 2 field trips a week!! Monday-Thursday • 9am-1pm • July 17th-August 24th • Ages 7-12. Fill out the form to apply for this scholarship.