Work Entry

MIX Middle School Summer Camp Scholarship Form

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Which Mountain Campus do you attend?

If you attend another church, please list the name of the church

Has your child previously attended Summer Camp?

Has your child previously received a scholarship for camp?

Registration Cost

$650.00

Scholarships require a $100 minimum payment. 100% scholarship will cover everything over $100

How much are you asking toward the cost?

If first scholarship option is not available, please choose a second option below

Second Discount option

Please briefly describe why you would like your child to attend Summer Camp with a scholarship.

Child's First Name

Child's Last Name

Child's Gender

Child's Date of Birth

Age of child as of September 1, 2026

Grade of child as of September 1, 2026

Submit