Payment Plan and Financial Aid Request Form

Payment Plan and Financial Aid Request Form

This form is required for anyone who would like to request a payment plan or financial assistance for Seed Song Camp Programs in 2026.
Please fill out this request form PRIOR to submitting a Camp Registration form.

Please note: Filling out this form does not guarantee approval or enrollment. Please allow ample time for requests to be processed by staff.

The information shared in this form is confidential and will be reviewed only by authorized Seed Song staff for the purpose of evaluating financial assistance or payment plan requests. We handle all submissions with care and respect for your family’s privacy.
- Please check "YES" if you plan to request for multiple children. A separate request form is required for each child.
  
  YESno
- Childs Name *
  
  First NameLast Name
- Childs Date of Birth*
  
  MonthDayYear
  Date
- Parent/Guardian Name *
  
  First NameLast Name
- Parent Email Address*
  example@example.com
- Parents Best Contact Number *
  Please enter a valid phone number.Format: (000) 000-0000.
- Parents Address *
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- I would like to:
  
  Request a payment plan (Skip to Section 2)Request Financial Aid (Skip to Section 3)Request both Payment Plan and Financial Aid (Fill out Section 2 and 3)
- I am requesting a payment plan for:
- (Skip for Spring Break Camp) How many weeks will my child attend summer camp?
- Whats the maximum deposit you can put down? ($100 minimum due at sign up)
- I am requesting financial assistance for:
- (Skip for Spring Break Camp) How many weeks will my child attend summer camp?
- Would $50 off per week cover your financial burden?
  
  YesNo
- Are you open to any barter agreements?
  
  YesNo
- To help us review financial assistance requests as fairly as possible, we ask for an approximate household income range. This information is confidential and used only for internal review.
  
  Under $40,000$40,000-$44,999Prefer not to say$50,000–$59,999$60,000–$79,999$120,000–$149,999$80,000–$99,999$100,000–$119,999$150,000 and above
- How many people are supported by this household income?
  
  123456 or more
- Please include any supplemental income documents that can help us understand your financial case (pay stub, tax return, ect). *
  
  Cancelof
- By signing below, I acknowledge that if my request for financial assistance or a payment plan is approved, I agree to pay the approved amount according to the agreed-upon schedule. I understand that failure to do so may affect my child’s continued participation in the program.*
  
  I agree
- Signature*
- Thank you for taking your time to submit this form. We thrive to make our programs accessible to all. Please allow ample time for requests to be processed by staff.
  
  Any questions or concerns should be addressed to camp@seedsongfarm.org
Should be Empty: