Parent/ Guardian Name
First Name
Last Name
How Many Campers?
Camper Name
*
First Name
Last Name
Camper Name
First Name
Last Name
Camper Name
First Name
Last Name
Camper Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
E-mail
example@example.com
Questions and Details:
Why are you requesting a scholarship?
Have you contacted your church about help paying for camp?
Yes
No
How much are you requesting as a scholarship? (Per child)
$25
$50
$100
Other
Type a question
Submit
Camper Name
*
First Name
Last Name
Should be Empty: