WAITLIST Camp Lookinback Scholarship Application

*CAMP SCHOLARSHIP APPLICATIONS ARE NOW CLOSED. COMPLETING THE FORM WILL ADD YOU TO OUR WAITLIST.*

If you are in need of financial assistance for your child(ren) to attend Camp Lookinback, please fill out the scholarship application form.

Once completed, we will contact you to inform you of your application status. If accepted, we will direct you to complete a camp registration form.

WAITLIST Camp Scholarship Application

Are you a Beaumont Heritage Society Member?(Required)

BHS Members – $65

Non-members – $75

Number of Campers(Required)

Please enter a number from 1 to 999

Camper(s) Name & Age(Required)

In case of emergency, and if the Beaumont Heritage Society is unable to contact any of the listed contacts, do we have permission to have your child taken to the emergency room?

Parent/Guardian Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Explanation of Need(Required)

Name

This field is for validation purposes and should be left unchanged.