2019 Camp Youth Seen Registration
Thank you for considering Camp Youth Seen for your teenager this summer! The dates for our camp this year are July 20-27th and will be located at Woodbine Ecology Center.

Once you register your child we will need a deposit of $50 -$100, which ever you can afford to secure your child's spot. This deposit will be applied to the cost of your youth's attendance. If you have any questions with the registration form please email info@youthseen.org. Looking forward to a great summer!

Email address *
Race
Campers Legal Name *
Your answer
Camper's Preferred Name *
Your answer
Age *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Pronouns *
Gender *
Sexual Orientation *
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Grade Completed *
Your answer
Allergies *
Your answer
Medications /Medical Alerts *
Your answer
Physical Restrictions *
Your answer
Parents/Guardian Information
Please provide name's of Parents/Guardian of camper
Parent/Guardian Information *
Your answer
Phone Number *
Your answer
Emergency Contact
This contact will be used if parent/guardian is unreachable
Emergency Contact Name *
Your answer
Relation to camper *
Your answer
Emergency Contact Phone *
Your answer
Is this emergency contact authorized to pick camper up in emergency? *
Cabin Mate Request - List One *
Your answer
Scholarship Information
We do have a few scholarship spots open for our campers. If you are interested in our scholarship offerings, please indicate below. From the submission of your form, we will be in contact to give you information on next steps for the scholarship process.
Would you like to apply for a scholarship? *
Deposit
Once you submit the campers information, we will respond with an email acknowledging that we received the information. Upon approval of the camper, we will send an email with a link for deposit and all other information that will be needed.
Submit
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