Camp MariposaYouth Application

Please fill out the form below.

Youth Applicant Information

The following information is used to gather demographic statistics.

Youth Activities

Youth Family Information

Youth Applicant History

Camp Mariposa has been providing services for youth and families experiencing issues such as addiction, poverty, abuse and mental health for over a decade. We recognize the following questions may be sensitive information to share, but this will help us plan and prepare a program that will benefit all youth. In the event of current abuse of any type, Camp Mariposa staff are mandated reporters.

Mental Health


Foster Care/Kinship Care


Parent/Guardian Contact Information

Emergency Contacts

Please list two people other than you to contact in case of an emergency at camp.

Additional Youth Information


Want to Get Involved?

Aaron’s Place needs people like you to help as mentors, camp facilitators, and volunteers.

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