By completing this form, your information and request for an adjusted session fee rate will be submitted. We will be in touch via email with your adjusted rate within 48 business hours.
OF NOTE: THE MAXIMUM DISCOUNT IS 45% AND MAY ONLY BE APPLIED TO A MAXIMUM OF 3 SESSIONS PER CAMPER AND NOT MORE THAN 4 TOTAL SESSIONS PER FAMILY.
YMCA of Greater Charlotte members should NOT submit this form. If you already have an approved My Y Pricing rate at your branch, it will automatically be applied to your Camp fee when you register. If you do not yet have a My Y Pricing rate at your branch, you will need to visit your home branch with a copy of your taxes to apply and have it assigned to your account. Once that process is complete, your My Y Pricing rate will automatically be applied to your Camp fee when you register.
Total Annual Household Income
A My Y Pricing Adjusted Rate is calculated off of your Total Annual Household Income. Please select the range in which your total household income falls. This is defined as: the total income line (1040 line 22, 1040EZ line 4 or 1040A line 15) on your tax forms. Your rate will be based on your income.
While we are not requesting to have your tax documents, we reserve the option to ask for them if clarification is needed prior to honoring an Adjusted Camp Rate.