Financial Assistance Interest Form

If you are seeking financial assistance for summer 2019 programs, please indicate your interest below. Financial assistance is available for those who qualify. Typically this equates to a total household income up to $115,000 for families sending one child and up to $130,000 for families sending two or more children to Camp.

Parent First Name *

Parent Last Name *

Parent Date of Birth *

Month

Day

Year

Mailing Address *

City, State, Zip *

Parent Email *

Parent Gender *

Male

Female

Camper First Name *

Camper Last Name *

Camper Date of Birth *

Month

Day

Year

Camper Gender *

Male

Female

Add a second child?

Yes

Second Camper First Name *

Second Camper Last Name *

Second Camper Date of Birth *

Month

Day

Year

Second Camper Gender *

Male

Female

Add a third child?

Yes

Third Camper First Name *

Third Camper Last Name *

Third Camper Date of Birth *

Month

Day

Year

Third Camper Gender *

Male

Female

Program *

Please let us know which program you are requesting assistance for.

Leave this field blank

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Financial Assistance Interest Form