Teencamps-UK Application Form
Information that we require
** Important - Please give as much detailed information as possible in your answers as this will be used to assess if your young person will be suitable to attend **
Information and Optional Services
Which type of camp/ service are you applying for? Please only tick the actual services you require
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Male One to One Camp in SPAIN - 7 day minimum
Male Behavioural Camp in UK or Spain - 7 day minimum
UK Male Group Camp - 7 day minimum
Online Consultancy
Family Home Visit
Male Mental Health Camp
Family Mediation
Dates required?
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Male One to One Camp in SPAIN minimum 7 days @ £3600.00 per week. No limit on the number of weeks you can stay. Please advise which dates you require from 1st June 2025 onwards.
Male Behavioural Camp in UK or Spain minimum 7 days @ £3600.00 per week. No limit on the number of weeks you can stay. Please advise which dates you require from 1st June 2025 onwards.
UK Male Group Camp 17th - 23rd August 2025 @ £2200.00 per week.
UK Male Group Camp 24th - 30th August 2025 @ £2200.00 per week.
UK Male Group Camp 31st August - 6th September 2025 @£2200.00 per week.
UK Male Group Camp 7th - 13th September 2025 @ £2200.00 per week.
Online Support Sessions @ £160.00 per 55 min session. Please advise suitable dates and times you require.
Family Home Visit-Minimum 3 days at £2200.00 plus expenses (total to be agreed).
Male Mental Health Camps- Price to be agreed.
Online Family Mediation- Price from £160.00 per 55 minute session
Are any Optional Services required?
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Pick up/ Drop off in Telford @ £180.00
Written Report @ £360.00
None - No optional extras required
Other services available. Please note this is not an official clinical medical diagnosis
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Autism Assessment @ £480.00
ADHD Assessment @ £360.00
Dyslexia Assessment @ £220.00
Anxiety Assessment @ £140.00
Depression Assessment @ £140.00
None of the above
Young Persons Details
Full Name of Young Person
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First Name
Middle Name
Last Name
Gender
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Male
Female
Age
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Date of Birth
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FULL details of issues and family history. Give as much information as possible.
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WHAT does the family hope this camp will achieve?
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How would you describe your parenting style?
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Are you open to changing your parenting style if necessary?
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Has the young person had Counselling previously? If Yes then please give FULL details of the type of Counselling received, how long, who with etc.
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Are they on any medication? If Yes then please provide details including prescription details, amount to be taken, how often, side effects experienced, etc.
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Do they have any current or previous mental health issues or have they ever been hospitalised? If Yes then please provide FULL details including dates, how long for, location etc
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Have they ever self harmed? If Yes then please give FULL details.
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Do they use drugs or alcohol? If Yes then please give FULL details of what they take, how much, how often etc.
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Do they have any previous criminal convictions or have they been involved in any recent criminal activity and have any court cases pending? If Yes then please give FULL details
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Do they have a disability? If Yes then please give FULL details
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Are they in education? If Yes then please give FULL details including school address. If not, then please advise what current education they are receiving
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Are they involved with any external Services (including Social Services)? If Yes then please give FULL details
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Do they have any allergies and are these life threatening? If Yes then please give details
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Do they have any special dietary requirements? If Yes then please give details
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Does the young person speak fluent English?
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Yes
No
Where did you hear about Teencamps-UK?
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Parents / Guardian Details
Parent / Guardian FULL NAME
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First Name
Last Name
FULL address and postcode
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Telephone Number
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Email Address
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Payment Method
I agree to pay in GBP (£) by
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BACS
Terms and Conditions
I have read, understood & agree to Teencamps-UK Terms & Conditions.
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Yes
I agree that I will collect my young person from camp if they are dismissed for any reason or if I chose to remove them. See T&C's on the website at www.teencamps-uk.com
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Yes
Submit
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