Apply for Family Camp!

 

This application is available to any family who has (or has lost) a parent or child who has been or is in treatment for cancer or sickle cell anemia within the last FIVE years Families outside of five years will be wait-listed. New participants and children or adults currently in treatment will given priority. Due to limitations of space and overall capacity, only children or adults living in the same household are eligible to attend.

Applicants are accepted into Camp Good Days programs free of charge, without regard to race, ethnicity, gender, gender identity or expression, religion, national origin, disability, or sexual orientation. Final acceptance shall be determined upon review.

* Denotes A Required Field

FAMILY INFORMATION
    
PATIENT INFORMATION
(If your family has more than one patient, please contact [email protected])
SESSIONS - All sessions will take place at the summer recreational facility in Branchport, NY

Sessions are offered at a LIMITED CAPACITY and are based off of patient grouping.
Participants will only be accepted into ONE PROGRAM SESSION.
Session dates are subject to change at the discretion of Camp Good Days.

 

CHECK-IN/OUT INFORMATION:
Sunday- Tuesday Sessions   Check In: 3 PM Check Out: 3 PM
Thursday- Saturday Sessions Check In: 11 AM Check Out: 11 AM
Day Only             Check In: 9 AM Check Out: 6:30 PM


CAMP PARTICIPANTS

Please list all participants who will be attending the session

 

Parents/Guardians

Are responsible for the actions and supervision of each child/participant throughout the program. At least one legal parent or guardian is required to attend.

All communication regarding the session will be sent to this contact (i.e. e-mail and postal mail).

Additional Adults

Please list any other adult (18 and older) living in your household who will be attending camp


Children

Please list all dependent children (age birth to 17) attending the session

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6
(If your family has more than 6 children, please email the requested additional child information to: [email protected])
HEALTH INSURANCE INFORMATION - Required to attend Camp Good Days programs