• Free to Live Membership Application

    Complete this membership application using the original form fields and consent/signature areas. Please answer all required items and provide accurate contact information.

  • As a Free to Live member, you become part of a community committed to your healing and growth. Members enjoy access to free and discounted services, priority notification and early registration for workshops and events, peer support circles, family-friendly programming, holiday and seasonal support, connections to trusted local resources, and members-only communications. When capacity allows, members may also access wellness partners, career and financial empowerment opportunities, and pathways to volunteer and lead. Above all, you'll have a community that sees you, celebrates your milestones, and walks alongside you on your journey.

    Membership Perks for Survivors — Young and Old

    Parents' Night Out | June 19, 2026 | Children ages 6–18 Dick's House of Sports is partnering with Free to Live to give kids two hours of fun-filled activity while parents take a well-deserved break. (A special registration link will follow once your application has been submitted.)

    Cup of Courage | June 20, 2026 | Adults Free to Live is partnering with Inclusion Coffee to offer a different kind of healing — one shared over coffee. Sign up to have your cup filled with practical techniques for moving past the trauma of domestic violence.

    A.L.P.H.A. Summer Youth Leadership Program

    For the next generation in our community, Free to Live proudly offers A.L.P.H.A. — Accountability, Leadership, Purpose, Health, and Advancement a free summer youth leadership program built for a season of growth, friendship, and purpose. Open to youth ages 11–16, A.L.P.H.A. surrounds young people with positive role models and a community that believes in who they're becoming.

    Across the summer, participants grow through five pillars:

    Mentorship — Positive role models and leadership
    Life Skills — Real skills for real life
    Fitness & Wellness — Move your body, strengthen your mind
    Financial Literacy — Smart money for a bright future
    Character & Leadership — Build confidence and lead with purpose


    The camp runs every Saturday from 9:00 AM to 2:00 PM, beginning Saturday, July 11, at our Pleasant Grove location (the exact site is shared at the Parent Information Meeting). Best of all, A.L.P.H.A. is completely free — made possible through Free to Live and our valued partners, including FTI Football Technical Institute, Simply Grace Gardens Foundation, Pink Print Strategy, and WealthWave.

    A Parent Information Meeting is required to attend, so families can connect with our team and learn what the summer holds. Because here, every young person gets the same invitation: Learn. Grow. Lead. This summer is yours.

  • Application / Contact / Eligibility

  • Date of Birth*
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  • Format: (000) 000-0000.
  • Permission to leave voicemail or send a text to this number*
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  • Eligibility & Consent*

  • Membership Details

  • Membership Option*
  • Date of Birth
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  • Date of Birth
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  • Date of Birth
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  • Programs of Interest
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  • Additional Information

  • Which types of support would be most helpful to you?

  • Final Agreements and Signature

  • Acknowledgment
  • Date*
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