Financial Assistance

63 days 'til Camp

Leaders Right This Way

Financial Assistance Application

Camper's Name
First Last
Date of Birth
Age
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Check one
- New Camper
- Returning Camper
Gender
- Male
- Female
Parent/Guardian 1
Parent/Guardian Email
Cell Phone
Home Phone
Work Phone
Household Members
List all children and adults (related or unrelated) who live in your household and share living expenses and/or meals. Do not include applicant. Please list ages next to those that are children
Household Income
Annual current income (including public assistance, child support, alimony, etc) for all members of your household before deductions (taxes and social security). If you receive more than one check from any of these sources, please indicate the total annual amount.
W-2 Employment EBT/Food Stamps SSI Child Support Subsidized Housing Disability
Upload Proof of Income
Max. file size: 50 MB.
What is your child's reason for wanting to go to camp?
Has your child had any previous camp experience? What Camp? When?
What do you hope your child will gain from their camp experience?
What can you afford to pay toward your child's camp fee?
NOTE: This application does not serve as acceptance to the financial assistance program. It should be noted that should the applicant be admitted in the program, assistance will end the last day of the camp session that the camper has applied for. Should your son or daughter, for any reason, not adjust to camp life, you will be advised by the camp director and asked to pick him/her up from camp.
By checking this box you hereby certify that the information your provided is correct to the best of your knowledge.
Parent/Guardian Name
Date
MM slash DD slash YYYY

W-2 Employment	EBT/Food Stamps	SSI	Child Support	Subsidized Housing	Disability