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 Last Name:

Participant's First 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.