FAMILY CAMP 2021 APPLICATION FORM

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 put on a wait-list. New participants and children or adults currently in treatment will be 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.

Please Note: Each accepted family is required to attend a virtual information session prior to arrival. You will need your health insurance information to complete this form.

* Denotes a Required Field

The form is not valid.