Youth Interest Form - Fit And Empowered Camp

Camp Components: Summer 2025 (June 2nd - August 7th)

Session 2: June 16th - June 26th

Session 3: June 30th - July 10th *

Session 4: July 14th - July 24th *

Session 5: July 28th - August 7th *

* Let's sign up for these sessions!

Physical Fitness: Engage in daily workouts, strength training, and fun activities like camp-themed line dances.

Health & Nutrition: Learn about heart health, juvenile diabetes prevention, and how to make healthy lifestyle choices.

Self-Respect & Discipline: Build confidence, develop leadership skills, and learn self-discipline through engaging activities.

Career & Entrepreneurial Skills: Discover different career paths and entrepreneurial opportunities to help prepare for your future.

Teamwork & Fun: Participate in team-based activities that promote camaraderie and fun while learning.

Student's Name

First NameLast Name

Your Email

example@example.com

Current Grade

School Name*

What school do you currently attend?

City

What city do you live in?

Gender

MaleFemale

What aspects of the camp are you most excited about? Choose all that apply.

Parent/Guardian Information

Name

First NameLast Name

Cell Number

Parent's Email

example@example.com

Additional Parent's Email

example@example.com

Does the student have ANY allergies, use an inhaler, illness, medical condition, or documented diagnosis? Ex. I wear glasses or use and inhaler. If YES, you attend camp for FREE!

YesNo

May we contact you via text, phone, or email to provide additional information about Fit & Empowered Camps.

YesNo