Camp Appalachia Summer Resident Camp Application
- Please fill out the following form for each child that will be participating in Resident Camp at Camp Appalachia.
- Resident Camp is open to all students between the ages of 7 and 17.
- Scholarships are available due to grant funding for children in Foster Care, Kinship Care, and kids who have a parent incarcerated.
- Questions? Please contact Camp Director Jared Davis at
What week of Resident Camp are you interested in?
June 15-17 (Elementary)
July 13-17 (Elementary) *Scholarships Available
July 20-24 (Middle/High School) *Scholarships Available
August 3-5 (Elementary)
Please help us get to know your camper
Camper's Full Name
Camper's Age & Date of Birth (Open to campers ages 7-17)
Camper's Phone Number - If Applicable
Camper's County of Residence
Does your child have any allergies? If yes, please list them below.
Does your child have any medications that will need administered throughout the week? If yes, please list/explain below:
Does your camper have any GOALS for the week?
Please provide information for parent/guardian in case of emergency.
Emergency Contact(s) Name & Best Phone Number
*** SCHOLARSHIPS ARE AVAILABLE***
Scholarships are available for children who are in Foster Care, Kinship Care, and Children who have a parent incarcerated.
Contact Me About a Scholarship
By clicking YES, I agree to pay $300.00 per child per week (If No Scholarship Awarded) )
Please contact me regarding payment
How to Pay:
Please make checks payable to "Camp Appalachia".
In memo line write - "Resident Camp Registration"
Mail or Drop Off Payment to Attn: Brenda Good, Church @ The Depot, 6496 Teays Valley Road, Scott Depot, WV 25560
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This form was created inside of Teays Valley Christian School.