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Apply NOW2019-10-25T15:53:59-05:00

All applicants must attend an interview to be considered for the Youth Challenge Program. The next step after completing this application is to attend one of our Interviews. A Youth Challenge Program representative will be in contact to set up an Interview time for you. If you have specific questions please contact us at 1-800-CAMP-KID.

Applicant Information





Male Female



Yes No





Currently Attending Dropped Out Stopped Going



Yes No



White Black Hispanic/Latino American Indian Asian Native Hawaiian

Legal Guardian #1 Information





Mother Father Step-Parent Grandparent Sibling Aunt/Uncle Other











Yes No



Less than 15000 15000 - 25000 25000 - 35000 35000 - 45000 Greater than 45000

Legal Guardian #2 Information





Mother Father Step-Parent Grandparent Sibling Aunt/Uncle Other


Yes No








Radio Word of Mouth Billboard TV

Alternate Emergency Contact - Not living in the same home as applicant