YMCA Camp Kirkwood Military Family Form

Parent/Guardian Information
Parent/Guardian First and Last Name
Home Address
City
State/Province
Postal/Zip Code
Parent/Guardian Phone Number (000-000-0000)
Parent/Guardian Email

Camper Information
Camper's First and Last Name
Age camper will be while attending camp
Camper's Date of Birth (MM/DD/YYYY)
Camper's Sex
Which camp are you interested in?
Is this the first time your camper is attending YMCA Camp Kirkwood?
 Yes
 No

Military Relation
Name of Military Member
Military member relationship to camper applying for scholarship
Veteran Status
Military Branch
Duty Station

Why YMCA Camp Kirkwood?
What benefit do you hope your camper will get out of their experience of a week of camp?
Where did you hear about this campership opportunity?
 

Once your application is received, a member of the YMCA will be connecting with you to follow up on your application and discuss the great experience of overnight camping for your family. Please allow for at least 2 business days for your application to be reviewed.
 

Parent/Guardian Signature

My signature indicates that, if my child is accepted, I agree to complete all camp online and in-person paperwork as needed by the camp for my camper to attend.