Campership Request Form

It is our desire at Camp Luz to not let finances keep any camper from being able to attend camp. This year has been especially difficult for many families. Generous donors have ensured that we have funds available to provide tuition assistance to anyone who needs it.

If you think you may need help paying for camp, please complete the form below.

Name of Camper

First NameLast Name

Parent/ Guardian(s) Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Email

example@example.com

Camp they will be attending:

What amount of the camp tuition are you (the family of the camper) able to pay?

Is your church able to assist with camp tuition? If so, how much?

Amount you are requesting from the Campership Fund

The total of these three should equal the cost to attend the week of camp.

Please state the reason that the campership is needed:

Please list the contact information for someone, other than yourself, who is familiar with your situation as a personal reference.

Reference Contact Name

First NameLast Name

Reference Contact Phone Number

Area CodePhone Number

Reference Contact Email

example@example.com

All Campership Requests will be processed on an individual basis and may take up to one business week to be approved. Confirmation will be sent by email upon approval. If you would perfer a different means of communication please call the office or email office@campluz.com after you submit this form.