Family Application Form

Please indicate which event(s) your family will be attending:
Family Weekend Retreat – Spring
Family Weekend Retreat – Fall
Back to School Event
Holiday Gathering
Parent(s)/ Gaurdian(s) attending:
Parent 1 Full Name
Relationship
Shirt Size
Parent 2 Full Name
Relationship
Shirt Size
Siblings attending:
Sibling 1 Full Name
Relationship
Birthday
Shirt Size
Sibling 2 Full Name
Relationship
Birthday
Shirt size
Sibling 3 Full Name
Relationship#Brother#Sister
Birthday
Shirt size
Child Who Passed Away:
Full Name
Gender
Date of Birth
Date of Death
Cause / Circumstances surrounding the death:
Was this an extended illness?
If so, how long?
Were they on hospice?
How did you explain the death to you other child/children?
Has your family or child/children received counseling or attended any grief support programs?
If yes, where?
Did your child attend the funeral service?
Has your child/children said or done anything that has concerned you (such as nightmares, bedwetting, special fears, caused harm to self or others)?
If yes, what
What do you want your child/children to gain from the camp/event experience?
What do you want your family to gain from the camp/event experience?
If there were something that we should know to better help serve your family, what would it be?
Contact Information
Mailing Address
Home Phone
Work Phone
Cell Phone
Email Address(valid email required)
Religious Affiliation (optional)
Is this your first time at a Camp Sol event
Language Preference for Parent Groups
Special needs
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Family Application Form

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