Camper Application
Welcome ! Steve’s Camp at Horizon Farms empowers young people to develop healthy bodies, hearts, and minds. Our summer camp program is the cornerstone of our work with youth. At camp, participants recruited from underserved New York City high schools spend twelve days living on a beautiful working farm in the Catskills – free of charge. Campers learn to create healthy living environments, develop positive leadership and collaboration skills, and striving to live self-reliant lives.

We are excited that you are taking the initiative to embark on this journey of self awareness, community development and giving space to challenge yourself!


Application deadline is February 1st, 2020!
Name *
First and last name
Your answer
When is your birthday ?
MM
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DD
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YYYY
What is your email? *
Your answer
What is your phone number? *
Your answer
What is your home address?
Your answer
Which school do you attend? (please include full name ie. Brooklyn Preparatory Academy High school)
Your answer
What grade are you currently in?
Which session are you available to attend camp? *
Please select one option.
Required
Parent/Guardian Name ( First, Last Name)
Your answer
Parent/Guardian Email Address
Your answer
Emergency Contact ( First, Last Name and Phone Number)
Your answer
Do you have any allergies (to medicine, food, animals, insects, grass etc)?
Your answer
Please select your dietary restrictions, if any.
Your answer
Are there any restrictions on activities your child can engage in at camp? If so, please list them here: (ie. Can not engage in rigorous physical activity more than 30 minutes etc)
Your answer
Please briefly provide context to your child's health history (if not listed, please select other and describe below)
If you checked any of the responses above, please explain here
Your answer
Does your child take any medication that they will bring to camp? Please list them here.
Your answer
If you'd like us to send the Medical Authorization directly to your family physician, please list their name, email address and/or fax number below.
Your answer
I understand and agree to Steve's Camp terms and conditions for acceptance.
I agree to fully participate and engage in all Steve's Camp activities and programming
I will pay my fully refundable $40 deposit
Any final questions, comments, or anything else that you would like us to know?
Your answer
Please briefly explain how you learned of Steve’s Camp.
Your answer
Any final questions, comments, or anything else that you would like us to know?
Your answer
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