Empowering Today’s Youth to be Proactive and Moral Leaders; Who will Greatly Impact the Lives of Those Around Them in a Positive Way
If you have any questions please feel free to email, call or text steveii@campironsights.com (907) 717-7556.
Camper Application
Please fill out the following information as complete as possible
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Primary Phone Number of Parent/Guardian
-
Area Code
Phone Number
Other Phone Number
-
Area Code
Phone Number
Email
example@example.com
Parent Guardian Primary Email
example@example.com
Parent/Guardian Secondary Email
example@example.com
Best way to contact you
Cell Phone
Home Phone
Parent/Guardian Phone
Other Phone
Your Email
Parent Guardian Email
Text
Parent/Guardian Name
First Name
Last Name
Relationship to you
Parent/Guardian Name
First Name
Last Name
Relationship to you
Date of Birth
Gender
Male
Female
Height
Weight
Shirt Size
Do you have a job?
Yes
No
If Yes, Who is your employer, What is your position, How many hours do you work each week?
Also please tell us if you can get time off work to attend camp
Please describe your living situation
Who do you live with; parent/guardian/siblings friends etc. Please list all.
Please describe your education
What grade are you in? What School do you attend? Are you on track to graduate? Please explain in detail.
Health Status
Excellent
Good
Poor
Unsure
Explain Health Status if Poor or Unsure
Are you currently taking any medications?
Yes
No
If Yes, Please list all
Please list any allergies you might have
Do you partake in any of the following? Please select all that apply
Marijuana
Alchohol
Tobacco
If you selected any please explain
Have you ever been treated for or struggled with any of the following? Please select all that apply
Depression
Anger
Mental Health Issues
Substance Abuse
Other
If you selected any please explain
Have you ever been arrested or imprisoned?
Yes
No
If Yes, Please explain
Family Annual Income
$0 - $10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000 - $100,000
$100,000 +
Payment Source
I can pay the full tuition for camp $6000
I can pay some of the camp tuition
I am willing to do some fundraising to pitch in towards my tuition
I need 100% scholarship to attend camp
If you can pay some of the tuition towards camp please explain below
Back
Next
Your answers to the following questions is what we primarily use as a determining factor of admittance to camp. The more in-depth and detailed your explanations are will give you a better chance of being accepted to camp.
Please describe any hardships (financial or other) that you and your family may be going through
Financial Problems, Family Loss, Homeless, Education Struggles, etc.
What are your goals, dreams and/or desires in life?
Short term and long term: Work/Career, Education, Financial etc.
Please list some areas in your life you would like to improve on
Personal struggles?
Please describe why you want to attend camp and what you hope to get out of the experience
Submit
Thank you for filling out the application to attend Camp Iron Sights
www.campironsights.com PO BOX 220563 Anchorage, AK 99522 (907) 717-7556 steveii@campironsights.com
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform