CampCares Application

Peer-Led Immersive Self-Healing Experience

PROGRAM COMMITMENT:

Phase I: 5-Day Prep - Virtual
Phase II: Live – 3 Live Immersion + 2 Travel = 5 Days
Phase III: 4 week Post Immersion Check In (Virtual)
Phase IV: VETCares Social Tribe Membership (optional)

Eligible Members: Veterans, Surviving Spouses, Gold Star, Community Heroes (firefighter, law enforcement, first responders)

2026 CampCares TRACKS

(CHOOSE ONE)

The Why Within- VAREP Member Camp: August 2-4, 2026 (VAREP Members Only)

Women’s Camp: SHE Matters: No 2026 event scheduled (Veteran, Surviving Spouse, Gold Star Family)

Men's Camp: Warrior Within: No 2026 event scheduled (Veteran, Surviving Spouse, Gold Star Family)

Join interest list

Note: Submission of an application does not guarantee acceptance. Participation is based on eligibility, cohort space, and program availability.

APPLICATION INFORMATION

How did you hear about this program? *

Other- How did you hear about this program?

Are you related to or do you have business ties to any VAREP staff, members of their immediate families, VAREP Board members, members of their immediate families, and such individual's business associates? *

Yes

MILITARY/ HERO DETAILS

Branch of Service/Hero Affiliation *

Military Status *

Pay Grade

Dates of deployments/ When will you deploy/ Location of deployments

Family Status *

Married

Single

Divorced

Widowed

Member 1- add Name, Age, and Relation to Applicant

Member 2- add Name, Age, and Relation to Applicant

Member 3- add Name, Age, and Relation to Applicant

Member 4- add Name, Age, and Relation to Applicant

Member 5- add Name, Age, and Relation to Applicant

Are you currently Employed *

Yes

Employer Name (If Yes)

Supervisor Name- If Employed

Supervisor Phone- If Employed

May We Contact Your Supervisor for Reference Check?

Yes

PROGRAM INVESTMENT – $8,500 per Participant

Program Overview

Phase I – Pre-Immersion (Virtual): Guided preparation and peer introductions prior to the live event

Phase II – Live Immersion (3 Days + Up to 2 days Travel): Facilitated peer-led cohort experience

Phase III – Post Immersion (4 weeks): Weekly accountability, peer check-ins, and implementation tracking

Phase IV—CampCares Social Tribe™ (12 Months): Ongoing virtual engagement and alumni support

Phase IV-a – HUD Approved Financial & Housing Counseling™ (Up to 12 Months) through USA Homeownership Foundation, Inc. DBA VAREP

PROGRAM INVESTMENT INCLUDES

Trained peer coach facilitation and program staff support across all program phases
Structured multi-day live immersion programming
Round-trip airfare (if applicable) and program-coordinated travel during the live immersion
Lodging accommodations during the live immersion
Group meals during live immersion
Program-related activities associated with the live immersion
Program materials and supplies
Pre- and post-program coordination
Twelve (12) months if CampCares Social Tribe™ membership
Up to twelve (12) months of HUD-Approved Financial and Housing Counseling™
Resource navigation and referrals (including HUD-VASH, SSVF, and other support programs, when appropriate)
Program administration and participant support services

Travel Notice: Airfare (if applicable) and travel arrangements are coordinated by the program and subject to scheduling, availability, and funding parameters.

Participant Program Investment Acknowledgement

I understand the full CampCare™ program investment is $8,500 per participant.

I acknowledge that I have reviewed what is included in the program investment.

FINANCIAL HARDSHIP REQUEST

I am requesting consideration for the Financial Hardship Grant (Grant awards are not guaranteed and are subject to review and available funding.)

Have you applied for any Financial Assistance in the past 12 months? *

Yes

If Yes to the question above, please provide the information requested below:

Name of Organization

Amount of Assistance

What unforeseen situation occurred that caused your need to apply?

Provide a detailed plan on how you will maintain future financial responsibilities if a grant were to be awarded:

FINACIAL STATEMENT

Income- Monthly Gross Amount *

Primary Employment (Gross)
Spouse/Co-Borrower Employment (Gross)
Self-Employment / Business Income
Retirement / Pension
Social Security
Child Support / Alimony
Other Regular Income
VA Service-Connected VA Disability (if applicable)

If other was selected, please explain

Total Monthly Household Income (all sources)

Expenses- Monthly Amount

Current Rent or Mortgage
Property Taxes (if separate)
Homeowners/Renters Insurance
HOA Dues
Utilities (electric, gas, water, trash)
Auto Loans/Leases
Credit Cards (minimum payments)
Student Loans
Personal Loans
Childcare
Child Support/Alimony Paid
Food & Household Supplies
Transportation & Fuel
Medical/Insurance Out-of-Pocket
Other Monthly Obligations

If other was selected, please explain

Total Monthly Expenses

LIQUID ASSESTS

Please list current balances. Enter $0 if not applicable.

Asset Type- Current Balance ($)

Checking Account(s)
Savings Account(s)
Money Market Account(s)
Cash on Hand

Total Liquid Assets:

HARDSHIP NARRATTIVE

Please briefly explain your financial hardship and why grant assistance is needed

Financial Hardship Acknowledgement

I understand the Financial Hardship Grant, if awarded, may provide up to $3,000 and I am responsible for the remaining balance.

I understand grant awards are not guaranteed and are based on eligibility, documentation, and funding availability.

I certify that the financial information provided is true and complete to the best of my knowledge.

CampCares PARTICIPANT ASSESSMENT

Are you currently working with a VA Counselor/ Therapist?

Yes

Have you been approved to attend an alternative therapy with any other organization? If so, what is the name of the organization and what dates will you be attending the program?

Have you attended, currently attending, or scheduled to attend other alternative programs? If so, please list them.

Have you obtained other grants/ resources in the past 2 years from other organizations? If so, please list each one.

Are you currently enrolled and/ or participatiing in an alcohol or drug rehabilitation program? *

Yes

Do you have any limitations to prevent certain activities?

Any medical assistance or special equipment needed to assist you while at the event?

Are you allergic to any medications, food, or other substances? If Yes, please list them:

Should you have an allergic event, what is your procedure? (If this doesn't apply to you, please enter N/A):

Are you currently taking any medications and/ or have specific needs that we should be made aware of (i.e., seizures, blackouts, etc.)? (If this doesn't apply to you, please enter N/A)

Please list below any concerns you may have while participating in the event.

IN CASE OF EMERGENCY CONTACT INFO

Name of Primary Emergency Contact

Name of Secondary Emergency Contact

GEAR SIZES/ INFORMATION

Shoulders (Inches) *

REFERENCES- LIST 2 REFERENCES

Phone (Reference 1) *

Phone (Reference 2) *

CampCares DOCUMENTS

Please Download each document below, read them carefully, sign each document, and upload them below in the corresponding section below.

DD214 *