Camp Registration

Register Today!

This summer camp provides a healing and supportive atmosphere free of charge for all children who have recently lost a loved one.

Camp Kangaroo Grief Camp Registration


SELECT CAMP LOCATION *

HOW DID YOU HEAR ABOUT CAMP? *

NAME OF CHILD ATTENDING *

YOUR NAME, PARENT OR GUARDIAN *

TELEPHONE *

EMAIL *

EMERGENCY CONTACT*

ALLERGIES *

MEDICAL CONDITIONS *

SPECIAL PERSON(S) WHO DIED: FULL NAME *

RELATIONSHIP *

AGE OF CAMPER AT THE TIME OF THE LOSS *

BRIEFLY DESCRIBE THE RELATIONSHIP BETWEEN THE CAMPER AND THE DECEASED.

ARE THERE ANY LANGUAGE, DISABILITY, OR OTHER NEEDS, FAMILY CUSTOMS, OR CULTURAL ASPECTS TO YOUR CHILD'S GRIEVING THAT WE SHOULD BE AWARE OF?

DOES YOUR CHILD HAVE DIFFICULTY WITH ANY OF THE FOLLOWING AREAS? CHECK ALL THAT APPLY. NoneSleepingEatingSchoolRelationships
DID YOUR CAMPER RESIDE WITH THE PERSON WHO DIED?*

PLEASE PROVIDE US WITH ANY OTHER INFORMATION ABOUT YOUR CHILD THAT WILL BE HELPFUL IN PROVIDING A SUPPORTING CAMP EXPERIENCE.

GENDER *

AGE *

T-SHIRT SIZE *



Thank you

Thank you on behalf of the Seasons Foundation Team and the patients and families your generous gift will help!