Select license type

Renew Camp Program License Only (CR, CD, CT, CV)

Renew Program and Site License (CR, CD, CT, CV, SR, SD)

Renew Camp Site License Only (SR, SD)

Update Camp Program License (CR, CD, CT, CV)

Update Camp Site License (SR, SD)

Camp Information

Camp Program Name

Camp Program License Number (CR, CD, CT, CV)

Camp (Site) Name

Camp (Site) License Number (SR, SD)

Camp (Site) Operation Address

Camp (Site) Operation City

Camp (Site) Operation State

Camp (Site) Operation Zip Code

Camp (Site) Operation County

Camp (Site) Operation Phone Number

Camp Director/Administrator Information

Name

Date of birth

Phone number

Does this person have a comprehensive background clearance or Livescan Fingerprint on file with the camp licensing unit?

Yes

Upload comprehensive background check or Livescan fingerprint

Licensee Organization Info

Organization Name

Organization Tax ID

Address

City

State

Zip Code

Phone Number

Fax Number

Website

Licensee/Licensee Designee Information

Name

Title

Phone Number

Does this person have a comprehensive background clearance or Livescan Fingerprint on file with the camp licensing unit?

Yes

Upload comprehensive background check or Livescan fingerprint

Additional Questions

Program Terms

Approved camper capacity

Is the camp accredited?

Yes

Upload proof of accreditation

Does the entire camp take field trips away from the site?

Yes

Upload field trip schedule

Upload sample daily schedule for camp program

Age Range of Campers

Youngest age

Oldest age

Session Dates

A children's camp operation is 5 or more days in a 14-day period. Upload a session schedule that includes all relevant camp sessions, including dates of sessions as well as start and end times of the camp day or session. You can upload multiple files if needed.

How many sessions?

Session 1 - Start Date/Time

Session 1 - End Date/Time

Session 2 - Start Date/Time

Session 2 - End Date/Time

Session 3 - Start Date/Time

Session 3 - End Date/Time

Session 4 - Start Date/Time

Session 4 - End Date/Time

Session 5 - Start Date/Time

Session 5 - End Date/Time

Session 6 - Start Date/Time

Session 6 - End Date/Time

Session 7 - Start Date/Time

Session 7 - End Date/Time

Session 8 - Start Date/Time

Session 8 - End Date/Time

Session 9 - Start Date/Time

Session 9 - End Date/Time

Session 10 - Start Date/Time

Session 10 - End Date/Time

Session 11 - Start Date/Time

Session 11 - End Date/Time

Session 12 - Start Date/Time

Session 12 - End Date/Time

Camp Site Terms

Camp Site Owner Name (if different than the licensee organization)

Address

Check all that apply:

Food service on site

Private well on site

Private sewer on site

What was the rating of the last environmental health inspection? (Residential camps)

Date of Last Environmental Health Inspection (Residential Camps)

What was the rating of the last qualified fire inspection? (Residential camps)

Date of Last Qualified Fire Inspection (Residential)

Approved camp site capacity

Upload Camp Site/Facility Map

Attestation of Understanding

Click to view each document:

Child Care Organizations Act (PA 116 of 1973)

Licensing Rules for Children's Camps and Adult Foster Care Camps

Background Clearances Required for Camp Staff

I agree to the following:

I have read and agree to comply with the Child Organizations Act 116 of 1973 and administrative rules regulating the operation of a camp.

I understand background check requirements for licensee designee, chief administrator, program director, and staff. In addition, I understand my responsibility to assess good moral character found in Act 380 of 1965.

I understand that a Qualified Fire Inspection for residential camps must be completed prior to issuance and every two years for continuation of the license status.

I understand that the Environmental Health Inspection Request must be submitted to my local health authority by May 1st each year (residential camps only) and an acceptable certification issued for continuation of the license status.

I certify that all information contained on this document is true and correct.

I certify the Licensee has a right to occupy the campsite.

I have the authority to submit this application on behalf of the licensee organization.

I agree to the following:

I have read and agree to comply with the Child Care Organizations Act 116 of 1973 and administrative rules regulating the operation of a camp.

I understand the background check requirements for licensee designee, administrator, program director, and staff. In addition, I understand my responsibility to assess good moral character found in Act 380 of 1965.

I certify that all information contained on this document is true and correct.

I have the authority to submit this application on behalf of the licensee organization.

Name

Payment Instructions

Before you submit this form, you must pay the application or renewal fee through the Michigan Department of Treasury’s payment portal (the link opens in a new window). After your payment is complete, copy the confirmation number and paste it into the field below. You won’t be able to submit the form without this number. Click here to open the payment portal

Fees

Program License (CR, CD, CT, CV)

Camper Capacity	Renewal Fee
5-100	$50.00
101+	$100.00

Site License (SR or SD)

Camper Capacity	Renewal Fee
5-100	$50.00
101+	$100.00

Payment Confirmation Number

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Step 1/ 7

Camp License Application

Camp Information

Camp Director/Administrator Information

Licensee Organization Info

Licensee/Licensee Designee Information

Additional Questions

Program Terms

Age Range of Campers

Session Dates

Camp Site Terms

Attestation of Understanding

Payment Instructions

Fees

Program License (CR, CD, CT, CV)

Site License (SR or SD)