Financial Assistance Request
Thank you for your interest in Camp Woodbrooke, a camp that believes in providing growth experiences to all who desire to participate, regardless of family financial means. Camp Woodbrooke provides financial assistance on an as-needed, first-served basis to applicants. Please complete the UltraCamp application found at our website, www.campwoodbrooke.org, before submitting this form. Use the Scholarship Application discount Campership24 to by-pass deposit requirement.
Camper Name
First Name
Last Name
Age
Camper Name
First Name
Last Name
Age
Camper Name
First Name
Last Name
Age
Which session(s) are your registering your camper(s) for?
Session 1 - Young Camper
Session 2 - Young Camper
Session 2 - Teen Trip
Session 3 - Young Camper
Session 4 - Young Camper
Session 4 - Teen Trip
Session 5 - Young Camper
City and State of residence
City
State
Number of people in your household
$$ Amount requested
Please tell us a little about your current financial circumstances, as you are comfortable/able.
Please check the possible sources of financial assistance you have already or might acquire:
Meeting or Church
Family
Friends
Local Foundations
County Agencies
Childcare Funds
ADC
American Camp Association
Other
Please list the total amount you anticipate receiving from the above sources (we understand that this amount could change.)
Is your family currently receiving TANF, SNAP, or DHS Subsidized Medical Services?
Please Select
Yes
No
Would monthly payments help you to manage the cost?
Please Select
Yes
No
Note:
Someone from Camp Woodbrooke will phone you after receiving your Financial Assistance Request form. Please let us know the name of the person to talk to, phone number, email, and the best days and times of day to reach that person.
Parent/Guardian name(s)
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Signature
Submit
Should be Empty: