EmailMeForm
Camp Conquer 2023 WAITLIST
Camp Conquer is a week-long camp for children ages 6-16 who have experienced loss due to the death of a loved one.
1
2
▶
1
2
Child's Name
*
First
Last
Child's Date of Birth
*
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
Child's Address
*
Does your Child have any allergies?
*
Yes
No
If your child has any allergies, please elaborate!
Parent/Legal Guardian
*
First
Last
Guardian's Email
*
Guardian's Phone
*
###
-
###
-
####
Second Emergency Contact
*
First
Last
Second Emergency Contact's Phone Number
*
###
-
###
-
####
What was the last grade your child completed?
Please Select One
Pre-k
Kindergarten
First
2
3
4
5
6
7
8
9
10
11
12
Please Select Your Child's Gender
*
Male
Female
Please Share With Us The Reason Your Child Is Attending Camp Conquer! Please be thorough as this helps us prepare activites for the camp.
*
1
/
2
