EmailMeForm
Camp Conquer Application 2025
Camp Conquer is a week-long camp for children ages 6-12 years old who have experienced the death of someone close to them.
1
2
▶
1
2
Child's Name:
*
First
Last
Child's Gender:
*
Child's Date of Birth:
*
MM
/
DD
/
YYYY
Child's Age (at the time of Camp):
*
Child's Ethnicity/Race:
*
Please select
Asian or Asian American
Black or African American
Hispanic or Latino
Middle Eastern or North African
Multiracial
Prefer not to answer
What grade will your child be completing in May 2025?
*
Please Select One
Pre-k
Kindergarten
First
2
3
4
5
6
7
8
9
10
11
12
Child's T-Shirt Size:
*
Please Select One
Child's Small
Child's Medium
Child's Large
Child's Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2XL
Adult 3XL
Address:
*
Street Address
City
State / Province / Region
Postal / Zip Code
Parent/Legal Guardian:
*
First
Last
Relationship to Child:
*
Parent/Legal Guardian's Phone Number:
*
###
-
###
-
####
Parent/Legal Guardian's Email:
*
Second Emergency Contact:
*
First
Last
Relationship to Child:
*
Second Emergency Contact's Phone Number:
*
###
-
###
-
####
Second Emergency Contact Email:
*
Has your Child attended Camp Conquer before?
*
Yes
No
How did you hear about Camp Conquer?
*
THBR Staff
THBR Website
Social Media
Marketing Event
Word of Mouth
Other
Please list any medical conditions including allergies, medications, special needs, etc. If this does not apply to your child, please list n/a.
*
Has your child ever been diagnosed with a disability? (This will NOT determine your child's eligibilty to attend Camp.)
*
Yes
No
If you answered yes above, please explain below. If this does not apply to your child, please list n/a.
*
List any behavioral disorders and/or mental health diagnosis below. Please include any other information you would like us to know for the week of Camp.
*
AUTHORIZED PICK UP:
Please list the persons authorized to pick up your child, including yourself. Each authorized person must be at least 16 years old. The child will not be allowed to leave Camp with anyone not listed below. Authorized persons may be required to show identification to Camp Staff.
*
First
Last
Additional Authorized Person
First
Last
Additional Authorized Person
First
Last
Additional Authorized Person
First
Last
Please share with us the reason your child is attending Camp Conquer! Please be thorough as this helps us to be more prepared for camp activities.
*
Please upload a photo of the child who will be attending camp.
*
Add File
Please upload a photo of the loved one who died.
Add File
Please click on the "Camp Conquer Consent Forms" button below to COMPLETE your child's registration.
1
/
2