Become a Camp Partner Camp InformationName First Last Email PhoneCamp Name Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code About the CampOn-Site Director(If Different From Person Completing the Form) First Last Specific Populations ServedAsthmaAutismBrain TumorCerebral PalsyCraniofacial DifferencesCystic FibrosisDeaf & Hard of HearingDealing with a Caregiver's Cancer DiagnosisDown SyndromeEpilepsyHeart DiseaseHomelessnessKidney DiseaseSickle Cell DiseaseTBITourette'sTransplantsCamper Ages 6–17 18+ What type of camp are you interested in? Weeklong, Overnight Weekend, Overnight What types of activities are you interested in? Horseback & Therapeutic Riding Waterfront Adventures Traditional Camp Activities Camp Dates & DurationStart Date MM slash DD slash YYYY Camp Dates & DurationEnd Date MM slash DD slash YYYY
