Outdoor Outreach Summer Adventures 2020: Tuition Assistance Questionnaire

Basic Information

	Parent/Guardian First Name:	Parent/Guardian Last Name:	Parent/Guardian Email:	Parent/Guardian Phone Number:	Participant's First Name:	Participant's Last Name:	Participant's Age:	Summer Adventures Session Dates:

Address Line 1

Address Line 2

City

State

Postal Code

Signature

Please provide your name confirming that the information you provided above is true.

Please initial to confirm your agreement to pay at minimum a tuition assistance fee of $20.00 for each child registered. This fee is non-refundable.