Parent/ Guardian Name
First Name
Middle Name
Last Name
Single Camper
Multiple 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
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 requested funding from a church or other funding source for assistance? If so, which ones?
Do you attend a church? If yes, what one?
Have you contacted your church about help paying for camp?
Yes
No
May we contact your church to coordinate with them?
Yes
No
What can you afford to pay?
How much are you requesting as a scholarship? (Per child)
$25
$50
$100
Type a question
Submit
Should be Empty: