Apply Now | Hooked on Healing Youth Camp (Ages 10

“Youth applying for Hooked on Healing summer camp” “Fishing-based mentorship program for teens” “Camper exploring healing in nature

Parent Guardian Full Name *

Camper First Name *

Camper Last Name *

Date of birth *

Age (10 -18) *

Age (10 -18)

School + Grade *

Gender *

Phone *

Address

Street Address

City

State

Country

Postal code

Email *

Allergies or Medical Needs *

Behavioral or Emotional Support *

Short answer: Why do you want your child to attend Hooked on Healing? *

Transportation Needed? *

T-Shirt Size

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