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Cart
0
Adventure Camp
About
Dates & Tuition
Registration
Adventure Camp Fund
Getting Ready for Camp!
Retreat Center
The Group Program
500 Acre Facility
Retreat FAQs
Weddings & Events
Weddings
Public Events
Summer Camp, Retreat Center, and Event Venue in Southwest Virginia.
About
History, Mission and Philosophy
Employment
Meet Our Staff
Connect
Map & Directions
Blog
Activities
Coming soon!
WA Fest
Adventure Camp Fund Application
Applicant Name
*
Applicant Name
First Name
Last Name
Parent's Name
*
Parent's Name
First Name
Last Name
Email Address
*
Phone Number
*
Address
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Today's Date
Today's Date
All applications must be submitted by April 1, 2018.
MM
DD
YYYY
What age will the applicant be in the summer of 2018?
*
Financial Information
This section will help us to see how the Adventure Camp Fund can best help your family.
Reason for requesting funds
Assistance will be given to families with various needs (Low-income, medical considerations, multiple children attending camps, etc.) and demonstrated enthusiasm for outdoor adventure. For this section, please briefly describe your families' situation.
How many people are in your household over the age of 7?
*
What is your total Yearly Household Income
*
Under 20,000
20,000-35,000
35,001-45,000
45,001+
Does the applicant qualify for the Federal free and reduced lunch program at school?
Yes
No
How much tuition can your family afford?
*
How much tuition assistance is requested?
*
Any assistance and subsequent remaining tuition will be based on the best discounted rate for trips: 30% off Classic Adventures, 25% off Specialty Trips. For example, you may apply for assistance with a one-week classic adventure and the Fund will attempt to assist you with covering $665 tuition.
Camp Selection
This section will describe the program the applicant may wish to attend
Has the applicant attended Wilderness Adventure before?
*
Yes, as a participant in Adventure Camp
Yes, as a member of a group (school, church, scout, etc.)
No
Please check which trips seem most appealing?
*
Outdoor Discovery (ages 8-10)
1 Week Classic (ages 11-17)
2 Week Classic (ages 11-17)
Climbing Specialty
Mountain Biking Specialty
All Girls 1-week (11-17)
Wilderness Leadership Course
Briefly Describe why the applicant is choosing a Wilderness Adventure program?
What makes the applicant an ideal recipient of the Adventure Camp Fund? Please explain what an Outdoor Adventure of this nature would mean.
Questions or Comments?
Please feel free to ask for clarification or more information for any aspect of the Adventure Camp Fund or Adventure Camp Program.
Thank you!
Thank you for your application. Please don't hesitate to be in touch if you have any questions.