Gold Star Summer Camp Application

    Please complete this online application. Spaces are limited.

    Contact Information
    Parent/Guardian Name *
    Parent/Guardian Name
    Name of Parent who Died in Combat/from Service-Related Injuries *
    Name of Parent who Died in Combat/from Service-Related Injuries
    Date of Death *
    Date of Death
    Address *
    Address
    Phone *
    Phone
    Participant's Name *
    Participant's Name
    Child or adolescent participant's name:
    Date of Birth *
    Date of Birth
    I can provide transportation to and from camp each day *
    Referral Information
    Pre-Survey Questions
    The information you provide in this survey will be kept strictly confidential and will only be used by Project Horse staff to ensure we are best able to meet participant needs. Please be as accurate and thorough as possible.
    Please Check All that Apply for Your Child(ren) *
    If applying for multiple children, please add details for each child here
    Please Check All That Apply to Your Child(ren) *
    Spaces are limited and submission of an application does not guarantee a spot. *