MeckMIN · IOOBY Interfaith Summer Camp Acceptance Form

CAMPER INFORMATION (THIS SECTION TO BE COMPLETED BY YOUTH PARTICIPANT)

I am excited about participating in MeckMIN In Our Own Backyard summer camp, June 10-13! I understand that I must be present all four days.

Camper's Name:

First Name

Last Name

Camper's Signature:

Current Grade:

T-shirt Size:

Dietary Restrictions:

Email:

Verify Email

Cell Phone:

PARENT/GUARDIAN INFORMATION (THIS SECTION TO BE COMPLETED BY PARENT/GUARDIAN)

I fully support my child's participation in MeckMIN In Oor Own Backyard Summer Interfaith Camp, June 10-13. I pledge that he/she will be present all four years.

Parent's Name:

First Name

Last Name

Parent's Signature:

Date:

(mm/dd/yyyy)

Email:

Verify Email

Phone 1:

Phone 2:

Camp Fee $250

I am paying the $250 camp fee (Please note: The actual cost per camper is $523 and MeckMIN works to raise the difference in sponsorships.)

Online

Amount

$250

$150

$

I am requesting financial aid in the amount of?

I am able to pay this amount

We are glad to offer financial aid as needed. Because we will raise the financial aid money and because of the limited space in this camp, please know that by accepting financial aid, you MUST commit to participating in all four days of the camp.

IOOBY Interfaith Summer Camp Acceptance Form - PAY ONLINE

CAMPER INFORMATION (THIS SECTION TO BE COMPLETED BY YOUTH PARTICIPANT)