Camp Kinard Adult Application

Adult Attendee Application

MUST BE A RESIDENT OF SOUTH CAROLINA
Children from 5 to 18 years of years of age, no exceptions (at least ONE adult must attend with a youth camper)
Lost loved one did not have to be a hospice patient for family to attend
The loss of your loved one must have happened within three months - three years from the date of camp
All applicants will be pre-screened before approval to determine if camp is appropriate for your family
There is a $50.00 application fee per family (ONLY to be paid if accepted to camp)
If your family should need the application fee waived, you will have the opportunity to apply for a waiver ONLY after your applications have been approved
Please note that applications are best filled out on a desktop or laptop and NOT a phone. Please, make sure you include a VALID email address that you CHECK REGULARLY as we communicate BY EMAIL. Also, EACH ADULT that applies needs a SEPARATE email address. Thank you for your understanding.

* Indicates required field

Name of Adult Applicant *

First

Last

Name of child attending camp with *

First

Last

YOUR (Adult's) 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 under their own email address) *

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 - PLEASE MAKE SURE THIS IS A VALID EMAIL YOU CHECK REGULARLY! EACH adult attending needs to input a SEPARATE email address, please. *

Primary Phone Number that can receive text messages - we use this for a lot of communications! *

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) *MUST BE BETWEEN 3 MONTHS - 3 YEARS FROM THE DATE OF CAMP *

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 $50.00 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 NOTsee 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.*