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4. SUMMER TEEN PACK CAMPERSHIP APPLICATION

   Use this application for the Summer Teen Pack program. Multiple applicants may be on one application. Any missing information may result in delay of application screening and/or denial of application. Approval for campership does not guarantee placement into the program. All approved applicants must register and pay the non-refundable reduced rate for the program to be guaranteed participation.

6. Campership Income Criteria

   Qualified applicants are eligible for a campership with their enrollment in the PG&E CARE program. Families must verify income eligibility and submit a copy of their most recent PG&E bill confirming CARE participation.

8. Parent First Name*
9. Parent Last Name*
11. Email Address*
12. Phone Number*
14. Address*
    PO Boxes and county road addresses will not be accepted
16. City*
17. State*
18. Zip Code*
20. Total Adults in Household*
21. Total Youth in Household*
25. Child #1 First Name*
26. Child #1 Last Name*
27. Child # 1 Birthday*
    Child # 1 Birthday
29. Child # 1 School*
30. Child #1 Entering Grade*
    -- Select One --6th7th8th
32. Child #1 will attend the following dates at Summer Teen Pack*

    1. Week 1: June 8-12
    2. Week 2: June 15-19
    3. Week 3: June 22-26

    1. Week 4: June 29-July 3
    2. Week 5: July 6-10
    3. Week 6: July 13-17

    1. Week 7: July 20-24
    2. Week 8: July 27-31
    3. Week 9: August 3-7
34. Summer Teen Pack conditions

    Once a campership has been awarded, you must pay the non-refundable fee of $50 per week to enroll in the program. 

    1. I acknowledge the conditions for Summer Teen Pack
36. Add another child

    1. I would like to add another child to this application
38. Child # 2 First Name*
39. Child # 2 Last Name*
40. Child #2 Birthday*
    Child #2 Birthday
42. Child #2 School*
43. Child #2 Entering Grade*
    -- Select One --6th7th8th
45. Child #2 will attend the following dates at Summer Teen Pack*

    1. Week 1: June 8-12
    2. Week 2: June 15-19
    3. Week 3: June 22-26

    1. Week 4: June 29-July 3
    2. Week 5: July 6-10
    3. Week 6: July 13-17

    1. Week 7: July 20-24
    2. Week 8: July 27-31
    3. Week 9: August 3-7
47. Summer Teen Pack conditions*

    Once a campership has been awarded, you must pay (the non-refundable) the reduced rate of $50 per week for enrollment into the program.

    1. I acknowledge the conditions for Summer Teen Pack
51. Campership Agreement*

    I understand once approved, I must pay the applicable discounted fees associated for each participant to guarantee enrollment into the program(s).

    1. I agree.
53. Proof of Income Qualification*

    Upload a copy of your most recent PG&E bill to verify enrollment in the PG&E Care program. If you are not enrolled in the Care program, you can submit a 2025 1040.

55. Proof of residency in Woodland*

    Upload a copy of your of utility bill, PG&E bill, or rental agreement to verify proof of residency in the City of Woodland.

57. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
59. Electronic Signature
60. Date
    Date
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

* indicates a required field