Overnight Camp Financial Assistance
Overnight Camp Assistance is available for children who reside in Kentucky/Southern Indiana and attend a non-profit Jewish overnight camp.
Name of Camper
*
First Name
Last Name
Age of Camper
*
Grade
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of contact person for this application
*
First Name
Last Name
Contact person's phone
*
Please enter a valid phone number.
Contact person's email
*
example@example.com
Name of the Jewish overnight camp the camper plans to attend?
*
What dates will your child attend camp?
*
Address of the Parent/Guardian completing this form, if different from child
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If applicable, name of other parent/guardian
First Name
Last Name
Synagogue/Temple, if applicable
Has your camper attended a Jewish overnight camp before?
*
Yes
No
We are requesting the following amount in assistance:
*
$500
$1,000
$2,000
$3,000
Other (Please contact Alison Roemer to discuss. 502-238-2730)
What is the total cost of the program and what sources of financing do you have other than this financial assistance?
*
Will the camper go if this financial assistance is not given?
*
Yes
No
Unsure
Text Message Opt-in (optional)
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