Basic Participant Application Form

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Camping to Connect is an experiential learning and mentorship initiative for underserved young men from New York’s inner-city communities.

Camping to Connect guides young men on an unfamiliar journey into the outdoors.

We want to ensure the safety of each participant by being informed of any injuries, allergies, and/or dietary restrictions, as well as having the proper clothing and footwear to feel comfortable and safe while camping and hiking.

We have access to basic gear available to borrow, and need to reserve them in advance.

Please provide your basic information by submitting the application form below.


Name *
Name
Address *
Address
Date of Birth
Date of Birth
For T-shirts, sweaters, fleece and/or rain jackets
For fleece and/or rain pants
Parent/ Legal Guardian/Emergency Contact *
Parent/ Legal Guardian/Emergency Contact
If under 18 years of age, you must enter the information for one of your parents or legal guardian.
Parent/Legal/Guardian/Emergency Contact Phone Number
Parent/Legal/Guardian/Emergency Contact Phone Number
Participant's Mobile Number
Participant's Mobile Number