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Scholarship Request

Cedar Lake Camp & Retreat Center

Please fill out the form completely.

 
For questions or more info: 931-823-5656 or clcstaff@cedarlakecamp.org.

Scholarship Request Form 2025

"*" indicates required fields

Address:*
Contact Name:*

CHILD ONE:

Gender:*
MM slash DD slash YYYY
Weeks you are applying for a camp scholarship

CHILD TWO:

Gender:
MM slash DD slash YYYY
Weeks you are applying for a camp scholarship

CHILD THREE:

Gender:
MM slash DD slash YYYY
Weeks you are applying for a camp scholarship

CHILD FOUR:

Gender:
MM slash DD slash YYYY
Weeks you are applying for a camp scholarship

CHILD FIVE:

Gender:
MM slash DD slash YYYY
Weeks you are applying for a camp scholarship

CHILD SIX:

Gender:
MM slash DD slash YYYY


Payment plan needed for balance after scholarship?*
Payment plans are auto-debited from checking or savings account

Cookout Scholarship Fundraiser

May 8th, 2026

Purchase Ticket here