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Parents
First Year Parent
Parent Information Hub
Health & Safety
Camp Schedule
Sample Menu
Homesickness
Camps
Summer Overnight Camps (Ages 8-14)
Summer Day Camps (Ages 5-10)
Summer Canoe Camp (Ages 13-18)
Fall Break Day Camp (Ages 5-14)
Spring Break Day Camp (Ages 5-14)
Navigate – Gap Year Program
Group Hold Form
Groups
Overnight Retreats
Field Trip & Day Use
Lodging & Facilities
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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 2024
"
*
" indicates required fields
Name of Family or Guardians:
*
Address:
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Name:
*
First
Last
Contact Phone:
*
Email
*
Church Name:
*
Church Phone:
*
Applying for Angel Tree Scholarship? (Child must have a parent/legal guardian that is incarcerated and has filled out the camper info form with Angel Tree):
*
Please Select
Yes
No
Father's Occupation:
*
Father's Gross Annual Income:
*
Mother's Occupation:
*
Mother's Gross Annual Income:
*
Total Number of Family living at home:
*
Number of children attending camp:
*
CHILD ONE:
Name:
*
Age:
*
Gender:
*
Male
Female
DOB:
*
MM slash DD slash YYYY
Grade Entering:
*
Camp Program:
*
Please Select
Day Camp
Overnight Camp
Weeks you are applying for a camp scholarship
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
CHILD TWO:
Name:
Age:
Gender:
Male
Female
DOB:
MM slash DD slash YYYY
Grade Entering:
Camp Program:
Please Select
Day Camp
Overnight Camp
Weeks you are applying for a camp scholarship
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
CHILD THREE:
Name:
Age:
Gender:
Male
Female
DOB:
MM slash DD slash YYYY
Grade Entering:
Camp Program:
Please Select
Day Camp
Overnight Camp
Weeks you are applying for a camp scholarship
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
CHILD FOUR:
Name:
Age:
Gender:
Male
Female
DOB:
MM slash DD slash YYYY
Grade Entering:
Camp Program:
Please Select
Day Camp
Overnight Camp
Weeks you are applying for a camp scholarship
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
CHILD FIVE:
Name:
Age:
Gender:
Male
Female
DOB:
MM slash DD slash YYYY
Grade Entering:
Camp Program:
Please Select
Day Camp
Overnight Camp
Weeks you are applying for a camp scholarship
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
CHILD SIX:
Name:
Age:
Gender:
Male
Female
DOB:
MM slash DD slash YYYY
Grade Entering:
Camp Program:
Please Select
Day Camp
Overnight Camp
Day Camp Weeks:
June 3-7
June 10-14
June 17-21
July 1-5
July 8-12
Overnight Camp Weeks:
June 2-8 (Overnight Camp)
June 9-15 (Overnight Camp)
June 16-22 (Overnight Camp)
June 23-29 (Canoe Camp)
June 30-July 6 (Overnight Camp)
July 7-13 (Overnight Camp)
Amount of scholarship desired:
*
How much can you pay?
*
Other Funding Sources:
*
How much is available from other funding sources?
*
Payment plan needed for balance after scholarship?
*
Yes
No
If scholarship is awarded, how many payments will you need after the scholarship?
*
If NO scholarship is awarded, how many payments will you need?
*
Please explain your need:
*
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