Black Loyalist Heritage Society
SUBSIDY APPLICATION
Cultural Summer Day Camps
Please read the guidelines below before completing this application.
Application must be received to be reviewed prior to participation to be considered for assistance.
PARENT / GUARDIAN NAME:
ADDRESS:
TELEPHONE:
EMAIL:
CHILD’S / CHILDREN’S NAME: (1)
(Up to 3 per family)
(2)
(3)
DATE OF DAY CAMP YOU ARE REQUESTING SUBSIDY FOR:
SIGNATURE OF PARENT / GUARDIAN:
DATE:
CONFIDENTIALITY OF ALL RECIPIENTS WILL BE PROTECTED
GUIDELINES FOR BLHS CULTURAL SUMMER DAYS SUBSIDY APPLICATION:

Assistance to children is designed to provide access to cultural opportunities.

Recipients must be under 12 years of age.

Maximum subsidy is 3 children per family once within a 12 month period.

Applications must be completed and submitted by parent / guardian prior to day camp registration
date.
Return Completed Applications to:
Black Loyalist Heritage Society
PO Box 1194
Shelburne, NS
B0T 1W0
Email: blackloyalist@blackloyalist.com
Tel: (902) 875-1310
Fax: (902) 875-1352
“Children are the world’s most valuable resources and its best hope for the future.” John Fitzgerald Kennedy