Summer Camp Sign-Up Form

Bryan Brown Youth Academy - 2026 Summer Application

This application collects required contact, medical, and permission information to participate in the program. Parent or guardian must fill out form to register their teen for our youth summer camp and provide required permissions and consent.
About the Program

The Bryan Brown Youth Academy is a week-long overnight leadership and career exploration program for Native youth ages 14–17.

Participants stay on-site for the duration of the program and take part in physical training, team-building activities, leadership development, and hands-on learning with public safety professionals and community leaders.

The Bryan Brown Youth Academy is made possible through the partnership and support of Freeport-McMoRan Inc., the Tohono O’odham Police Department, Desert Diamond Enterprises, and community partners.

The academy is named in honor of Officer Bryan Brown, who was deeply committed to supporting and mentoring youth in the communities he served. For more information about the Bryan Brown Foundation please visit the Bryan Brown Foundation offical website.
Program Details

Dates: Sunday, May 31 - Saturday, June 6

Camp Location:
Southern Pines Baptist Camp 12602
E. Organization Ridge Road Mt. Lemmon, AZ 85619
Camp Website

Transportation:
Parents/guardians are responsible for drop-off and pick-up at the BUSD Intermediate Campus Parking Lot on May 31 and June 6. Exact times will be provided to families before the program start date.

Participants should reside on or near the Tohono O’odham Nation due to transportation requirements.
Eligibility Requirements
- Native youth between ages 14–17 at time of program
- Must follow program rules and safety instructions
- Parent/guardian must give permission to attend
- Must submit completed application and required releases
Participant Information

Tell us about the teen attending camp.
Teen's Full Name*

First NameLast Name
Tribe (and village if applicable)
Teen's Age
Age by May 31, 2026
Teen's Email Address (if available)
example@example.com
Teen's Phone Number (if available)
Please enter a valid phone number.Format: (000) 000-0000.
Teen's Shirt Size
Teen's Shoe Size

Parent/Guardian Information

A parent or legal guardian must complete this section.
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name (other than parent/guardian)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Medical Information
Does the participant have any medical conditions that may limit physical activity? (If yes, please specify)
AsthmaDiabetesOther
Does the participant have allergies (including food)? (If yes, please specify)
Is the participant taking prescribed medication? (If yes, list medication, dosage, schedule)
All medications must be in original labeled containers and turned in to staff before camp activities begin.
Participant carries EpiPenParticipant carries inhaler

Liability, Parental Permission and Photo Release Consent

Please review this page with your teen and provide your consent below.
PARTICIPANT EXPECTATIONS (Please review with camp participant)
- I will respect participants, staff, and camp property, including keeping the camp clean.
- I will represent myself, my family, community, and the Tohono O'odham Nation in a positive way.
- I understand this is a safe and sober program. Only approved medications listed in my Medical Information section are allowed.
- I understand weapons, gang-related activity, or gang-affiliated attire are not allowed.
- I understand my parent/guardian or emergency contact may be notified for medical, behavioral, or safety concerns. I understand communication may be delayed due to limited signal.
- I understand that if I become ill, unsafe, or display inappropriate behavior, my parent/guardian may be required to pick me up.
- I understand additional rules may be given for specific activities and sessions.
I agree to follow all program expectations. I understand that if I do not follow program rules, I may be removed from the program and my parent/guardian will be responsible for transportation home.
I understand that Youth Academy staff and Southern Pines Baptist Camp are not responsible for lost, damaged, or stolen personal property. I am responsible for my own belongings during the Bryan Brown Youth Academy.
I understand that the Bryan Brown Youth Academy, Southern Pines Baptist Camp, and partners are not responsible for injuries or illness related to participation in activities, facility use, or equipment. I accept these risks and release these organizations, staff, and volunteers from related claims. Parent/guardian and participant understand the risks involved.
I give permission for my teen to participate in the youth academy and authorize the use of photographs/videos taken during camp activities for promotional purposes.
Parent/Guardian Signature*
Signature
Parents/guardians are required to complete this application.

Camp participants must complete a brief pre-camp survey (which will be provided by camp staff) and a post-camp survey on the final day of camp. These surveys support program evaluation and funding.

Additional activity-specific release and liability waivers may be required. Any required forms will be provided and collected prior to the start of summer camp.
Should be Empty:

Bryan Brown Youth Academy - 2026 Summer Application

Participant Information

Parent/Guardian Information

Medical Information

Liability, Parental Permission and Photo Release Consent