Adult Application

Adult Attendee Application

-MUST BE A RESIDENT OF SOUTH CAROLINA
- Children from 5 to 18 years of years of age (at least ONE adult must attend with a youth camper)
- Lost loved one did not have to be hospice patient for family to attend
- The loss of your loved one must have happened within the past three years
- You will be responsible for travel to and from event location
- There is a $50 application fee per family (only to be paid if accepted to camp)
- If your family should need your application fee waived, you will have the opportunity to apply for a waiver after your applications have been approved.

* Indicates required field

Name of Adult Applicant *

First

Last

Name of child attending camp with *

First

Last

Date of Birth (MM/DD/YYYY) *

Name of additional adult attending with (if applicable; each adult attending much fill out their own individual adult attendee application) *

First

Last

Name of second child attending camp with (if applicable) *

First

Last

Name of third child attending camp with (if applicable) *

First

Last

Name of fourth child attending camp with (if applicable) *

First

Last

Contact Information

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Primary Phone Number *

Secondary Phone Number *

County *

General Information

Gender *

Adult's T-Shirt Size *

Ethnicity *

How did you hear about Camp Hands of Hope? *

If your family has a military affiliation, please list it here. If not, type n/a *

Medical Information

Do you have any Dietary Restrictions, Allergies (food or non food), or hypersensitivities? (if yes, please explain; if no, please type "n/a") *

Do you have any medical, physical, or mental health conditions of limitations? (if yes, please explain; if none, please type "n/a") *

Bereavement Information

Name of loved one who passed away *

First

Last

Were you present at the time of loss? *

Date of Death (MM/DD/YYYY) *

Cause of death *

Relationship of deceased to you *

Did you attend the funeral/memorial service? *

Other losses or life changes you would like to share (ie. pet loss, divorce, moving, illness, etc.) *

Questions, comments, or concerns that you may have *

- Applications are evaluated on a first come first serve basis; after receiving your completed applications, a team member will contact you to set up a time to speak with you more about what to expect at camp.
- Families that have attended camp two or more times previously will be wait listed and require an interview.
- Families that have attended camp two or more times previously are not eligible for a registration fee waiver.

- If accepted into camp, you will need to pay the $50 family registration fee or complete a registration waiver fee.

The Hospice & Palliative Care Foundation does not discriminate on any basis of who is accepted into camp.

Please type your name below to certify this information. *

Note: Please make sure that each person - child or family member - attending camp has submitted an individual application. For example, if a mother is bringing two of her children, three applications must me submitted - one "Adult Application" for the mother and two "Child Applications" for her children.

Submit Application

*Please make sure you have completed all areas of this application. IF YOU DO NOT SEE A "Completed Application" notification on the page once you click "Submit Application", please review the application and look for any red boxes and stars, indicating a required field you may have failed to complete.*