Youth Respite Registration Form

    Personal Information
    Parent/Guardian Information
    Emergency Information
    Medical Information


    Helpful Information
    Payment Information

    The Camp Connections Respite program is $25 per evening/day. Thanks to our sponsors, tuition assistance is available if needed.
    We require financial statements for verification, such as proof of income and/or disability related expenses. Please contact us at or or 214-351-2500 ext. 2273 to be considered.

    Please check before submitting.