Registration Form
Family Camp Aug. 2-8
FAMILY GROUP INFORMATION
Please try to keep all campers in your group that plan to lodge together on one form (with a maximum of 10). If campers are paying separately, we ask that the main contact collects tuition payments before paying. This helps us keep track of tuition balances.
Family Group Name
*
Lodging Request
Cabins sleep up to 10 (singles & bunks); Retreat Center sleeps 3/room (singles). Requests will be processed on a first come, first served basis and cannot be guaranteed.
Total Number of Campers in Group
*
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CAMPER 1 (MAIN CONTACT)
The email listed below will receive a confirmation message that contains important paperwork and information regarding your camp session.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Tuition Due, Camper 1
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CAMPER 2
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 2
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CAMPER 3
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 3
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CAMPER 4
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 4
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CAMPER 5
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 5
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CAMPER 6
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 6
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CAMPER 7
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 7
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CAMPER 8
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 8
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CAMPER 9
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 9
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CAMPER 10
Name
*
First Name
Last Name
Day(s) Attending
*
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Age
*
Additional Information
Guardian signature is required:
Tuition Due, Camper 10
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SIGNATURE & PAYMENT
To register, a deposit is required (includes 4% processing fee):
*
Non-Refundable Deposit One Camper ($52.00)
Non-Refundable Deposit Two Campers ($104.00)
Non-Refundable Deposit Three Campers ($156.00)
Non-Refundable Deposit Four Campers ($208.00)
Non-Refundable Deposit Five Campers ($260.00)
Non-Refundable Deposit Six Campers ($312.00)
Non-Refundable Deposit Seven Campers ($364.00)
Non-Refundable Deposit Eight Campers ($416.00)
Non-Refundable Deposit Nine Campers ($468.00)
Non-Refundable Deposit Ten Campers ($520.00)
Full Tuition Cost
Payment Selection
Please select a payment method for the remaining balance due:
I will pay by mail or in-person using check, cash, or card
I would like DSHS/DDA to be billed for the remaining fees
I would like to request a campership
Paying By Mail or In-Person
Camp Burton will send an invoice to the main contact email listed on or around June 15. This invoice will document today's payment and show the remaining tuition balance due on or before the first day of your camp session.
DSHS/DDA Contact
Name
First Name
Last Name
Email
example@example.com
Campership Request
It is part of our mission to make summer camp accessible to all regardless of a camper’s financial situation. We encourage you to request assistance if you need it. Financial aid typically goes to those who have many dependents or are facing financial hardship. This process is honor-based and confidential. Our funds are limited, we might not be able to grant every financial aid request.
How much can be paid towards the remaining tuition amount?
Minimum: $50 per camper non-refundable deposit
Does the camper/family receive any other benefits (SNAP, DSHS, etc.)?
Yes
No
Please provide us with any other information you think we should know.
Today's Total
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USD
Payment Methods
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