Camp Registration

Register for Camp Kangaroo or Virtual Support

Our Camp Kangaroo plans may be tentative because of Covid-19, but our commitment to our community and our campers is constant. Our dates for Camp Kangaroo are currently tentative, dates may change, we may provide virtual support, but we will be here to support your family.

Please register below and we will contact you with date or location changes as well as any plans for virtual support groups, online resources, etc.

Camp Kangaroo Grief Camp Registration


SELECT CAMP LOCATION *

HOW DID YOU HEAR ABOUT CAMP? *

NAME OF CHILD ATTENDING *

CHILD'S STREET ADDRESS *

CHILD'S CITY *

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!