PCI's Summer Camp Waitlist

We believe every child should have the opportunity to experience summer camp, regardless of financial circumstances. Thanks to the support of our community and generous partners, a limited number of scholarships are available to help families participate in our summer camp programs. If the cost of camp would prevent your child from attending, we encourage you to complete this brief application. All information will be kept confidential and used only to help us fairly distribute available scholarship funds.

Sign in to Google to save your progress. Learn more
Email *
Your name? *
Your Phone Number? *
Student's name? *
What grade is your student currently enrolled in this 2025-2026 school year? *
What school did they attend? Please answer even if out of state so we can report to our grantors. *
Does your student have any medical conditions we need to know of that may require care such as inhalers, sun sensitivities, allergies, etc?  *
Which weeks are you wanting to be added to the waitlist? Please only pick dates you need to allow spots for other families. *
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pagosa Community Initiative.

Does this form look suspicious? Report

Google Forms