Kids-N-Camp Fund

Important: Read first

All information must be filled in for the application to be considered.
Please fill out one form for each child.
Please do not fill out more than one application per child.
Filling out an application does not guarantee funding.
If any information is not entered correctly, the entire application will be automatically rejected.
Please apply soon as possible, as there are only a limited amount of applications that can be reviewed.
Kids in Camp is designated for children 9 -16.

I have read all of the above and I understand.

I understand that if this applicant receives Youth Corp funding, the money will be returned to the fund.

Child/Family Infomation

Child's First Name

Child's Last Name

Age

Grade

Father's First Name

Mother's First Name

Home Address

City

State

Zip

Phone Number

Cell Number (Optional)

Number of unmarried children

Number of children looking to go to camp

Where is family for the summer first half?

Where is the family for the summer second half?

Shul Affiliation

Rav Name

Rav Phone Number

Yeshiva/School Child Attends

Rebbi/Teacher Name

Cell Number

Menahel/Principal Name

Cell Number

Camp Information

First Half Camp

Name of Sleepaway Camp

Name of Day Camp

Official Camp Name (to make check out to)

Camp Director Name

Camp Director Phone

Total Projected Cost of Camp

Are you receiving any discount from the camp?

Yes

Total discount

Second Half Camp

Name of Sleepaway Camp

Name of Day Camp

Official Camp Name (to make check out to)

Camp Director Name

Camp Director Phone

Total Projected Cost of Camp

Are you receiving any discount from the camp?

Yes

Total discount

Financial Aid

Are you receiving financial aid from other organizations? If yes, list which ones.

Did you receive funding from Kids-n-Camp Fund in the past?

Yes

The Kids-n-Camp Fund’s mission is to help those children who will not be able to go to camp/day camp without our assistance. Do you affirm that all funds are needed?*

Yes

Are there any extenuating circumstances we should be aware of?

References

Reference name can not be any other name used in this application or family member. They must be 2 different people. If references do not follow these rules the entire application will be automatically rejected.

Reference #1

Reference Name

Cell Number

Reference #2

Reference Name

Cell Number

Note: If you do not receive email for each child confirming receipt of application, application was not received.

Scholarship Application

Important: Read first

Child/Family Infomation

Camp Information

First Half Camp

Second Half Camp

Financial Aid

References

Reference #1

Reference #2