Parent/Guardian Information

Name

Phone Number

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Address

Student Information

Student Name

School

Grade - Current School Year

Financial Information

The total cost of the middle school weekend camp trip is $260. Please answer the following questions to help us determine an appropriate scholarship for you. Keep in mind, we have a limited amount of scholarship funds and desire to use them to help as many students as we might need to, so we always ask families/students to pay as much as they are able to pay.

How much of the $260 camp cost are you able to afford?

Are you able to pay the $100 deposit at this time?

Please provide any information you're comfortable sharing about your financial circumstances that might help us determine a scholarship amount.

Is your son or daughter willing and able to work alongside their Young Life leader to earn money toward camp? If no, please explain.

Please provide any other information you think would be helpful.

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