Maryland Wilderness Camp for Troubled Boys

About Your Child

Please fill in the following information about the child you are considering enrolling in camp.

Name*

First Last

Sex*

Date of Birth*

Age

We're sorry, but Allegany Boys Camp only accepts boys 9–15 years old. To discuss possible alternatives for your child, feel free to call us at 301-478-5721.

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Geocoder

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Geocoder

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Address Where the Child Lives*

Distance (Miles)

Approximate Travel Duration

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Directions, Distance & Routes

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Travel Time

To keep families involved with a boy’s progress through the program, we normally accept applications from a radius of 4–5 hours from camp. If you would like to discuss the possibility of an exception, please contact us.

About You

Name*

First Last

Email*

How Are You Related to the Child?*

What’s Your Current Marital Status?*

How Did You Hear About Camp?*

How Can We Reach You?

Your Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type*

Phone Number*

Type*

Alternative Phone Number

Height of Child*

Weight of Child*

Is your child enrolled in a residential program now?*

Name of Program*

Why Are You Considering Camp?*

In one or two paragraphs, describe the problems you are having with your child.

Find Out If Camp Is Right for Your Boy

About Your Child

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About You

How Can We Reach You?