• South Shore YMCA, Camp Burgess & Hayward Financial Assistance Application

  • CAMP FILLS QUICKLY! Your camper must be registered (here) with a paid deposit of $50/week of camp prior to filling out this application.

    Filling out this form does not secure you a spot in camp. To be considered for financial assistance, this form must be submitted by April 1st, 2027.

    To pay the deposit or ask any questions, please contact us at 508-428-2571 or camp@ssymca.org. If you would prefer to submit your application by mail, please click this link and print out the form. Mail the completed form to:

    Camp Burgess & Hayward
    75 Stowe Rd Sandwich MA, 02563.

    Please note: financial assistance is available for a maximum of two weeks of programming per child, per summer, except for campers participating in the CIT program. Any additional sessions for each child must be paid at full price.

  • Household information

  • Format: (000) 000-0000.
  • Please list all people living in your household, including yourself*
    Rows
  • Have you ever applied for financial assistance before from Camp Burgess & Hayward?*

  • Camper(s) Information

  • Participant #1

  • Date of birth of participant #1*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is participant #1 attending another camp session?*
  • Do you have another child attending camp?

  • Participant #2

  • Date of Birth of participant #2*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is Participant #2 attending another camp session?*
  • Do you have another child attending camp?*

  • Participant #3

  • Date of Birth of participant #3*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is Participant #3 attending another camp session?*
  • Do you have another child attending camp?*

  • Participant #4

  • Date of Birth of participant #4*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is Participant #4 attending another camp session?*

  • Financial Information

    Please itemize you monthly, pre-tax income and expenses

  • Monthly Pre-tax Income

  • Monthly Pre-tax Expenses

  • Financial Records

    Please make sure to black out all Social Security numbers if present on the forms, as well as bank account numbers or any other personal information you may have on your records. We will not accept documents with SSNs or other personal information still visible. You will have to reapply if these are included.

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  • Sharing stories of the impact of Camp Burgess & Hayward helps us to spread the word about the impact of Camp Burgess & Hayward, and raise funds, which allows us to offer camp scholarships. Would you be willing to let us share your family's Camp Burgess & Hayward story?*

  • Financial Assistance Deposit

    If you did not already register and pay a deposit online, you must pay a $50 deposit per participant, per program/session. Completing this form does not hold a spot at camp for your child.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: