Good For Kids Camp Jones Gulch Scholarship ApplicationGood For Kids Camp Jones Gulch Scholarship Application

 


Steps:
1. Click on 'Printer Friendly Version' at the bottom of this page.
2. Print this Page.
3. Complete all the fields.
4. Send this application to:

Good For Kids
PO Box 170297
San Francisco, CA 94117

415 354-4238 Fax

Please note: We will award scholarships on a first come/first serve basis.

Child Information (Kids, please complete the following)

Name: ________________________________________________________  Date of birth:________________
(Last, First, Middle, Nickname)

Address: __________________________________________________________________________________
(Street, City, State, Zipcode)

School Name: _______________________________________________ Grade this Fall: __________________

Are you a YMCA Member?: (circle one) Yes   No   At which YMCA?: ___________________ Since:____________

How did you hear about Good For Kids?: __________________________________________________________

Which camp session would you like to attend?: (circle one)    3rd (7/24-7/29)     4th (7/31-8/5)    5th (8/7-8/12)

1) What is your favorite artistic or athletic thing to do? Why do you like to do it?

 

 

2) What are your 3 favorite things to do when you are not studying? Why?

 

 

3) If you could teach one thing to a friend, what would it be? Why?

 

 

Parents/Guardian Information (Parents/Guardians, please complete, then sign and date at the bottom.)

Name: __________________________________________________ Relation to child: ___________________
(Last, First, Middle)

Name: __________________________________________________ Relation to child: ___________________
(Last, First , Middle)

Cell #: _________________  Home #: ________________   E-mail Address: ___________________________


Submission of this application to Good For Kids and acceptance of a Good For Kids Camp scholarship does not entitle the child or the parents/guardians to any additional goods or services from Good For Kids. In the event that the child is selected to participate in additional phases of the Good or Kids Program, any amount or duration of services provided to the child will be at the sole discretion of Good For Kids.

Child and Parents/Guardians give Good For Kids irrevocable rights, copyrights, and permissions, in connection with the photographs/negatives/videos/digital images taken of them during the Camping Scholarship period, to use and reuse said photographs/negatives/videos/digital images either by themselves or in conjunction with other photographs/negatives/videos/digital images in any medium and for any purposes whatsoever as well as using their names in connection therewith.


_________________________________________________________________
Parent/Guardian Signature

________________________________________
Date