2019 Summer Camp Scholarship Application

Are you interested in a Summer Camp Scholarship at Fernbrook Farms!?

Please complete the application and if you have any questions, please don't hesitate to call us (609-298-4028).

To be eligilble, your child must qualify for free/reduced lunch and live in Trenton or surrounding area.

Is your child eligible for free/reduced lunch? *

Is your child from Trenton or surrounding area? *

Scholarships are available for one week of camp per summer. Transportation is provided from the locations indicated during each week. Families are responsible for picking-up/dropping-off their children from the specified locations.

Please rank the following weeks/pick-up locations in order of preference. Selections will be based on a first-come, first-served basis. If your first choice has already been filled, we will contact you.

	July 15-19: Grant School (159 N. Clinton Ave) & Robbins School (283 Tyler St)
	July 22-26: Parker School (820 S Warren St) & Mott School (45 Stokely Ave)
	July 29-August 2: Monument School (145 Pennington Ave) & King School (401 Brunswick Ave)
	August 5-9: Robeson School (350 Cuyler Ave)
	August 12-16: Washington School (331 Emory Ave) & Franklin School (200 William St)
	August 19-23: PJ Hill School (1010 E. State St.) & Wilson School (175 Girard Ave)

Camper Information

First Name *

Last Name *

Age (during camp) *

Birthday (mm/dd/yy) *

Sex: *

School *

Grade (next fall) *

Previous summers at Fernbrook *

Photo Agreement * 🛈

Parent/Guardian Information

Parent/Guardian #1 Contact Information:

First Name *

Last Name *

Primary Phone # *

Secondary Phone Number *

Email Address *

Confirm Email Address *

Street Address *

City *

State *

Zip Code *

Address Line 2

Employer *

Parent/Guardian #2 Contact Information:

First Name

Last Name

Primary Phone #

Secondary Phone Number

Email Address

Confirm Email Address

Street Address (If different from above.)

City

State

Zip Code

Address Line 2

Employer

Emergency Contact Information (Please provide a different person than listed above):

First Name *

Last Name *

Relationship to You *

Primary Phone Number *

Secondary Phone Number *

How did you hear about Fernbrook Farms' Summer Camp Scholarships? *

Camper Medical Information

If not applicable, please indicate N/A in the related field.

Please list all known allergies and treatment if exposed. *

Please list any behavioral or other pertinent information Fernbrook staff should know to ensure your child has a positive camp experience. *

Please list any past medical treatments that would pertain to your child's success at camp. *