2018 Summer Camp Scholarship Application

SCHOLARSHIPS FOR 2018 ARE COMPLETELY FILLED!

IF YOU ARE STILL INTERESTED, YOU MAY COMPLETE THE FORM TO BE PUT ON THE WAITLIST.

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 16-20: Grant School (159 N. Clinton Ave) & Robbins School (283 Tyler St)
	July 23-27: Parker School (820 S Warren St) & Mott School (45 Stokely Ave)
	July 30-August 3: Monument School (145 Pennington Ave) & King School (401 Brunswick Ave)
	August 6-10: Robeson School (350 Cuyler Ave)
	August 13-17: Washington School (331 Emory Ave) & Franklin School (200 William St)
	August 20-24: 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. *