Responsibility Summer Camp

Gift Information

Donation Amount*
$



1 Child x 1 Week

=

$40

2 Weeks

=

$80

3 Weeks

=

$120

4 Weeks

=

$160

2 Children x 4 Weeks

=

$320

5 Children x 4 Weeks

=

$800

10 Children x 4 Weeks

=

$1,600

 

Contact Information

Country*
State / Province*
Address*
City*
*
*
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*
*
*
Email*
Confirm Email*
Phone*

Payment Information

Amount*
$
Name on Card*
Card Number*
Additional Comments

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