Camp Life 2026 Registration
Ride the Waves of Resilience at Camp Life 2026! 🌊This summer, youth will join us at the University of Montevallo for an unforgettable camp experience filled with fun, new friendships, and valuable life skills. Camp Life is designed for IL youth to connect, learn about helpful IL resources, and to enjoy a few days away in a supportive environment. 2026 Camp Sessions: 🌊 June 9–11 (Ages 14–16) 🌊 July 14–16 (Ages 17–20)
I am registering for:
Camp Life 1 (June 9 - 11; Ages: 14 - 16) *Registration closes: May 22nd at 5 pm!*
Camp Life 2 (July 14 - 16; Ages: 17 - 20) *Registration closes: June 26th at 5 pm!*
Camper Name
First Name
Last Name
Camper Preferred Name
Camper County
Camper Sex
Camper Gender Identity
Camper Date of Birth
-
Month
-
Day
Year
Date
Camper T-shirt Size
Extra Small
Small
Medium
Large
Extra Large
2X
3X
4X
Social Worker Name
First Name
Last Name
Social Worker Email
example@example.com
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Names of siblings also applying to Camp Life
Please check any behaviors that the youth has displayed or diagnoses given in the PAST.
Anger
Anxiety/Fear
ADD/ADHD
Aggressive Behavior
Attachment Disorder/Attachment Issues
Autism/Asperger Syndrome
Bedwetting
Bipolar Disorder
Depression
Developmental Delay
Eating Disorder
Headaches/Migraines
Manipulative Behavior
Mood Swings
Sensory Issues (i.e. sensitivity to noise/sound, lights, etc.)
Sexual Behaviors
Shyness
Sleep Issues/Sleepwalking
OCD
Other (i.e. afraid of the dark, fear of thunderstorms, etc.)
Please check any behaviors that the youth is currently displaying and/or current diagnoses
Anger
Anxiety/Fear
ADD/ADHD
Aggressive Behavior
Attachment Disorder/Attachment Issues
Autism/Asperger Syndrome
Bedwetting
Bipolar Disorder
Depression
Developmental Delay
Eating Disorder
Headaches/Migraines
Manipulative Behavior
Mood Swings
Sensory Issues (i.e. sensitivity to noise/sound, lights, etc.)
Sexual Behaviors
Shyness
Sleep Issues/Sleepwalking
OCD
Other (i.e. afraid of the dark, fear of thunderstorms, etc.)
If any behaviors or diagnoses are checked above, please provide detailed information here (Please include the category checked as well)
Does your youth have any physical limitations?
Yes
No
If yes, what are they? If no, type N/A
Has this youth been hospitalized for psychiatric care within the last 6 moths?
Yes
No
If yes, please provide details here:
When this youth becomes angry, anxious, or dis-regulated, do they run/flee/run away?
Yes
No
If yes, please provide details here:
What is the preferred bus stop for this Camper?
Birmingham
Hunstville
Montgomery
No transportation needed
Please list all prescription medications currently taken by the camper and diagnosis requiring the medication. (*Note: This information will be updated prior to camp*)
Submit
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