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

All applications must be submitted by April 1, 2018.

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

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.)

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.

Adventure Camp Fund Application

Thank you for your application. Please don't hesitate to be in touch if you have any questions.

Join the community:

(540) 864-6792 • 11176 Peaceful Valley Road New Castle, VA 24127
Summer Camp | Adventure Camp | Teen Camp | Retreat Center | Conference Center | Virginia