Please list the address at which you'd like to receive a confirmation email.
Please provide the phone number at which we can reach you most reliably.
Please include wages, unemployment, social security/disability, state/federal aid, or other support in your income.
This form is limited to 3 campers per form.
We are asking that you pay a minimum amount of $200 per camper. The actual cost of a week of camp is over $600 for one camper.