Camper Information Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4- 10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25, 2021) 3 (June 28-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 9-13, 2021) No Preference
Do you need assistance getting these items before your child’s week of camp? Other*
Would you like to add additional Campers?* Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27- July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021 No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25, 2021) 3 (June 28-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 9-13) N/A
Do you need assistance getting these items before your child’s week of camp? Other*
Would you like to add additional Campers?* Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27- July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25 2021) 3 (June 26-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 7-13, 2021) No Preference
Do you need assistance getting these items before your child’s week of camp? Other*
Would you like to add additional Campers?* Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25, 2021) 3 (June 28-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 9-13, 2021) No Preference
Do you need assistance getting these items before your child’s week of camp? Other*
Would you like to add additional Campers?* Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25, 2021) 3 (June 28-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 9-13, 2021) No Preference
Do you need assistance getting these items before your child’s week of camp? Other*
Would you like to add additional Campers?* Full Name*
First
Last
Birth Date* Gender*
Grade for Fall of 2021* - select - 1 2 3 4 5 6 7 8 9 10
School 2021-2022*
First Year Attending Camp Ernst* Are you interested in fee assistance for week-long overnight camp?* Overnight Camp Week Preference 1st choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Overnight Camp Week Preference 2nd choice* - select - 1 (June 13-19, 2021) 2 (June 20-26, 2021) 3 (June 27-July 3, 2021) 4 (July 4-10, 2021) 5 (July 11-17, 2021) 6 (July 18-24, 2021) 7 (July 25-31, 2021) 8 (August 1-7, 2021) No Preference
Cabinmate Request (optional)
Interest in Horse Camp Scholarship if available (age 10-12 only)?* Interest in Day Camp Fee Assistance?* Day Camp Week Preferences* - select - 1 (June 14-18, 2021) 2 (June 21-25, 2021) 3 (June 28-July 2, 2021) 4 (July 5-9, 2021) 5 (July 12-16, 2021) 6 (July 19-23, 2021) 7 (July 26-30, 2021) 8 (August 2-6, 2021) 9 (August 9-13, 2021) No Preference
Do you need assistance getting these items before your child’s week of camp? Other*
Mailing Address*
Parent Guardian Information Parent/Guardian #1*
First
Last
Phone #1*
Phone #1 Type* - select - Home Cell Work
Phone #2*
Phone #2 Type* - select - Home Cell Work
Email*
Parent/Guardian #2
First
Last
Phone #1
Phone #1 Type - select - Home Cell Work
Phone #2
Phone #2 Type - select - Home Cell Work
Email
Income Information Total Number of Adults and Children in Household* - select - 1 2 3 4 5 6+
Total Household Gross Income Per Year* - select - $0 - $18,999 $19,000 - $30,000 $30,001 - $40,000 $40,001 - $55,000 $55,001+
(Total household income including child-support, unemployment, public assistance, and other before deductions or “adjusted”/AGI on tax forms)
Please explain why you want your child to attend Camp Ernst?*