2025 Summer Camp Scholarship Application Form

Family Information
Parent 1
Parent Name

First NameLast Name
Home Phone

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Camp Information
Name of Camp
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Camp Begins

MonthDayYear
Date
Date Camp Ends

MonthDayYear
Date
Check to be made payable to:
Name of staff member to contact at camp:
Phone Number

Area CodePhone Number
We are requesting a camp scholarship of   $   to be paid by Upside of Downs, Inc. as follows:
Deposit of $, which is due to the camp by     Date
Balance of camp cost   $   to be paid by Upside of Downs, Inc. to the camp by   Date   .
In the case that the family must cancel the camp reservation, I First Name Last Name, parent of First Name Last Name, agree to reimburse the Upside of Downs, Inc. for any amount of camp payment that Upside of Downs, Inc. has paid on behalf of my camper that is not fully refundable to Upside of Downs, Inc. by the camp organization.
Signature

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Date

MonthDayYear
Date
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Summer Camp Scholarship Application Form