Campership ApplicationPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.SSCYC tries to help any camper who needs financial assistance in order to attend camp. Please know that we don’t want to deny anyone the opportunity to attend camp, however, the demand for financial assistance is often high, and our resources are limited. We work with your church or youth group to provide as much assistance as possible. Families are expected to pay at least the $250.00 registration fee for each camper at a minimum. Parent / Guardian Information First Name *Last Name *Address *Address Line 1CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Church or Youth Group *Member ChurchFirst Church in WeymouthFirst Congregational Church of BraintreeOld South Union ChurchPilgrim Church of DuxburyUnion Congregational Church of Weymouth and BraintreeUnited Church of Christ NorwellGuestCamper Information Please list each camper along with their date of birth that you have registered for camp this year. Children 1 this Camper 1 First Name *Camper 1 Last Name *Camper 1 DOB *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper 2 First NameCamper 2 Last NameCamper 2 DOBMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper 3 First NameCamper 3 Last NameCamper 3 DOBMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper 4 First NameCamper 4 Last NameCamper 4 DOBMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Camper 5 First NameCamper 5 Last NameCamper 5 DOBMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Campership Information The following information is necessary in determining Campership awards and is kept strictly confidential. How many people in your household? Adults *Children *Total amount requested for Campership? (Evenly split across all your campers.) Total Amount *Please explain your circumstances to validates this request. Failure to provide this will delay our ability to review your request.Submission Instructions Please type your name below as a digital signature. By clicking “Submit Application,” you certify that all information above is true and accurate. SignatureSubmit Application