Campership Application

Started in 1977, the Camp Stella Maris Campership Fund provides need-based scholarships for camp programs. Our goal is to ensure that all children can experience the loving and magical environment of Camp Stella Maris. This effort is funded through the generosity of our donors and our annual Campership Fund Benefits. Over the years, recipients of this award have come back as staff members, board members, and leaders in our community. As you can see, we all benefit through this endeavor - and therefore it is with great pride we welcome you to the Campership Program.

Please complete this form to submit your campership application. All information provided will be held strictly confidential, and is necessary for us to determine an appropriate award. Campership aid is available for one session per child per year. We will award based on the information we receive from you. Please do not hesitate to add or send any additional information you think would be beneficial to your case. We will do our best to meet your needs, however limited our funds. You will be informed of the award within 2 weeks of submission*. Payment in full of the remaining balance is due June 1, 2026. If you have any questions, please contact our Business Manager, Carlin Bell directly at 585-346-2243 x 105.

*Applications received before January 1, 2026 will be notified of an award in January.

Camper 1 Name *

First

Last

Camper 1 Date of Birth *

Camper 2 Name

First

Last

Camper 2 Date of Birth

Camper 3 Name

First

Last

Camper 3 Date of Birth

Camper 4 Name

First

Last

Camper 4 Date of Birth

Are any of these children receiving aid from the Department of Social Services? *

Yes
No

Social Services Case Information

Child 1 Case #

Child 1 Case Worker Name and Phone #

Child 2 Case #

Child 2 Case Worker Name and Phone #

Child 3 Case #

Child 3 Case Worker Name and Phone #

Child 4 Case #

Child 4 Case Worker Name and Phone #

Parent/Guardian Information

Parent/Guardian 1 Name *

First

Last

Email *

Phone *

Parent/Guardian 2 Name

First

Last

Email

Phone

Name of person completing this form (if different from parent/guardian listed)

First

Last

additional that additional

The Child(ren) live with:

Child(ren)'s Primary Address *

Address Line 1

Address Line 2

City

State

Zip Code

Child(ren)'s Secondary Address

Address Line 1

Address Line 2

City

State

Zip Code

Registration Information

Your child must be currently enrolled in a Camp Stella Maris program to receive a Campership award. A $75 deposit is required to enroll in all summer camp sessions. If your Campership award is not sufficient to allow your child to attend camp, you may cancel your registration and will receive a full refund of your deposit.

Please select the programs for which your child(ren) are enrolled. *

*

I have confirmed that my child(ren) are enrolled for the above programs and I have paid the required deposit(s).

Household Income Information

All information collected will be kept strictly confidential.

What is your current estimated yearly gross income for your household? *

Number of children living in your household: *

Are you a single parent/guardian? *

Yes
No

How much will the other parent/guardian be contributing to the camper's registration?

Is there any additional information you wish to share about your financial circumstances that would be helpful in determining an award?

Please upload a copy of your most recent 1040 tax return which clearly lists your name, dependents, and total income. Your information will be kept strictly confidential. *

Click or drag a file to this area to upload.

Please upload a copy of your 2 most recent pay stubs or additional source of income. Your information will be kept strictly confidential. *

Click or drag files to this area to upload. You can upload up to 4 files.

I certify that the information provided in this form is accurate to the best of my knowledge. I understand that if I am offered an award that is not sufficient to allow my child to attend camp, that I may cancel my registration and receive a full refund of my deposit. *

Clear Signature

Social Services Case Information

Parent/Guardian Information

Registration Information

Household Income Information

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