2026 YIP x USC Boys Application | Youth Impact Program

2026 USC YIP APPLICATION FORM FOR BOYS

Please use this form to apply for the 2026 Boys Youth Impact Program at the University of Southern California

YOUTH INFORMATION

First Name of Youth Participant(Required)

Last Name of Youth Participant(Required)

Nickname of Youth Participant

Gender(Required)

Male

Female

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address City ZIP Code

State(Required)

Date of Birth(Required)

Grade Level as of Fall 2026(Required)

School(Required)

School District(Required)

Does the Youth Participant have knowledge of STEM?(Required)

Yes

Is the Youth Participant part of a Military Family?(Required)

Yes

Height(Required)

Weight (in lbs)(Required)

T-Shirt Size(Required)

Shorts Size(Required)

Does your child have any medical/physical conditions?(Required)

Is your child currently on medication?(Required)

Does your child have any allergies?(Required)

Please list all medical conditions, allergies and medications(Required)

If none, please write none or n/a

Parent Guardian Information

Name of Parent or Guardian(Required)

Relationship to student(Required)

Cell Phone Number(Required)

Email(Required)

Enter Email Confirm Email

Secondary Contact information

If we cannot reach you, who should we call for emergencies?

Name(Required)

Relationship to Student(Required)

Cell Phone Number(Required)

Statement of Responsibility:

I, the Legal Guardian, understand that in completing this application, I support my child in participating in this academic and athletic program(Required)

I will not schedule vacation time or admit my child into other camps during the program dates, otherwise I forfeit their spot as to allow another camper to attend(Required)

I assume FULL risk and responsibility for their commitment and participation in this program and I agree to waive any claims against the YIP and the Host Organization(Required)

Entering Parent/Guardian name here authorizes legal representation for youth participation(Required)

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