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Circle Crew Application 2025
Circle Crew is a 3-day camp for teenagers ages 13 to 17 years old who have experienced the death of someone close to them.
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Teen's Name:
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First
Last
Teen's Gender:
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Teen's Date of Birth:
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MM
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DD
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YYYY
Teen's Ethnicity/Race:
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Please select
Asian or Asian American
Black or African American
Hispanic or Latino
Middle Eastern or North African
Multiracial
Prefer not to answer
Teen's Age (at the time of Camp):
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What grade will your teen be completing in May 2025?
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Please Select One
Pre-k
Kindergarten
First
2
3
4
5
6
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Teen's T-Shirt Size:
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Please Select One
Child's Medium
Child's Large
Child's Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2XL
Adult 3XL
Address:
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Street Address
City
State / Province / Region
Postal / Zip Code
Parent/Legal Guardian:
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First
Last
Relationship to Teen:
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Parent/Legal Guardian's Phone Number:
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Parent/Legal Guardian's Email:
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Second Emergency Contact:
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First
Last
Relationship to Teen:
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Second Emergency Contact's Phone Number:
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Second Emergency Contact Email:
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Has the teen attended Camp Conquer before?
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Yes
No
How did you hear about Circle Crew?
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THBR Staff
THBR Website
Social Media
Marketing Event
Word of Mouth
Other
Please list any medical conditions including allergies, medications, special needs, etc. If this does not apply to your teenager, please list n/a.
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Has your teenager ever been diagnosed with a disability? (This will NOT determine their eligibility to attend.)
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Yes
No
If you answered yes above, please explain below. If this does not apply to the teenager, please list n/a.
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List any behavioral disorders and/or mental health diagnosis below. Please include any other information you would like us to know for the week of Camp.
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AUTHORIZED PICK UP:
Please list the persons authorized to pick up your child, including yourself. The teen will not be allowed to leave Camp with anyone not listed below. Authorized persons may be required to show identification to Camp Staff.
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Last
Additional Authorized Person
First
Last
Additional Authorized Person
First
Last
Additional Authorized Person
First
Last
Share with us the reason your teen is attending our 3-day camp! Please be thorough as this helps us to be more prepared for camp activities.
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Please upload a photo of the teen who will be attending camp.
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Add File
Please upload a photo of the loved one who died.
Add File
Please click on the "Camp Consent Forms" button below to COMPLETE your teen's registration.
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