Sickle Cell Family Camp Registration

Sickle Cell Family Camp

For kids with sickle cell ages 5-12 and their immediate family members.
Welcome to Happiness Is Camping's application! This application form is for Sickle Cell Family Camp. Family Camp is for kids with sickle cell ages 5-12 and their immediate family members. Family Camp dates are as follows:
- Session 1: Saturday, July 29 – Monday, July 31
- Session 2: Tuesday, August 1 – Thursday, August 3
I acknowledge that I am registering a child with sickle cell between the ages of 5-12 for Family Camp.*

Yes

Camper Information

"Camper" means your child with sickle cell.
What is your Camper's name (aka the name of your child with sickle cell)?

First NameLast Name
When was {CamperName:first} born?*

MonthDayYear
Date
{CamperName:first} is a:*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Sickle Cell Diagnosis Information

This section will gather some info regarding your Camper's sickle cell diagnosis.
We're so excited that {CamperName: first} wants to join us for Family Camp! Please tell us a little bit about their sickle cell diagnosis.
Sickle Cell Diagnosis*
Type of Sickle Cell
Name of {CamperName:first}'s home hospital/treatment center.*
Name of Doctor (Hematologist or Pediatrician)*
Name of Child Life Specialist/Social Worker
Child Life Specialist/Social Worker your child works with, if applicable.
Child Life Specialist/Social Worker Email
example@example.com

Family Member Registration

This section is where you will register all other Family Members attending with your Camper.
Eligibility Requirements

Please note that only immediate family members are eligible to attend. This includes parents, legal guardians, and siblings.

Other caregivers such as a grandparent or aunt/uncle may be considered on a case-by-case basis. To see if a caregiver qualifies, please email Ryan at ryan@happinessiscamping.org or call him at (908) 619-9937.

COVID-19 Requirements

Happiness Is Camping's Medical Council has determined that all attendees must be fully vaccinated for COVID-19. "Fully vaccinated" means they received at least their primary series of shots. Our Medical Council recommends that each participant stay up to date with their booster shots. Click here for more information about the COVID-19 vaccine.
How many people in total will be attending Family Camp (including {CamperName:first})?*
Please list everyone who will be attending with {CamperName:first}. To add another person, hit the Add Another Attendee button.*
Have all attendees been fully vaccinated for COVID-19?*

YesNo
Please list anyone who is not fully vaccinated for COVID-19 and if they will be fully vaccinated prior to attending.*

Session Selection

This is where you will choose which session your Family will attend.
Now for the fun part! This page is where you will tell us which session your family will be attending.

Please note: Families can only attend one session.

Sickle Cell Family Camp Dates:
- Session 1: Saturday, July 29 – Monday, July 31
- Session 2: Tuesday, August 1 – Thursday, August 3
Please check which session your family would like to attend.*

Session 1: Saturday, July 29 – Monday, July 31Session 2: Tuesday, August 1 – Thursday, August 3

Parent/Guardian Information & Emergency Contact
This is the final step! Please add any relevant parent/guardian contact information and include at least one emergency contact.
Parent/Guardian 1 Name*

First NameLast Name
Relationship to Child with Sickle Cell?*
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 1 Phone Number (Mobile)*
Please enter a valid phone number.
Parent/Guardian 1 Phone Number (Home)
Please enter a valid phone number.
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like to add a second parent/guardian?*

YesNo
Parent/Guardian 2 Name*

First NameLast Name
Relationship to Child with Sickle Cell?*
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number (Mobile)
Please enter a valid phone number.
Parent/Guardian 2 Phone Number (Home)
Please enter a valid phone number.
Parent/Guardian 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Information

Please note: Emergency Contact MUST be different from parent/guardian.
Emergency Contact Name*

First NameLast Name
Relationship to Camper*
Emergency Contact Phone Number (Mobile)*
Please enter a valid phone number.
Emergency Contact Phone Number (Home)
Please enter a valid phone number.
Emergency Contact Email
example@example.com
Emergency Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like to add a second Emergency Contact?*

YesNo
Emergency Contact 2 Name*

First NameLast Name
Relationship to Camper*
Emergency Contact 2 Phone Number (Mobile)*
Please enter a valid phone number.
Emergency Contact 2 Phone Number (Home)
Please enter a valid phone number.
Emergency Contact 2 Email
example@example.com
Emergency Contact 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Paperwork Requirements
Mandatory paperwork must be submitted by June 1. Please be advised that registration is not 100% complete until all mandatory paperwork has been uploaded. A member of the HIC Staff will email you with instructions to upload required paperwork.

Paperwork Requirements to Attend

Child with Sickle Cell:
- Health Form (Child with Sickle Cell)
- Health History Form
- Insurance Card (Front and Back)
- COVID-19 Card
All Other Attendees:

The following items are required for EACH participant:
- Insurance Card (Front and Back)
- COVID-19 Card (for everyone 5+)
If you have them readily accessible, you can upload any of these files here. Please note that this is not required at this time.

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Cancelof
I agree to upload all required paperwork by June 1.*

Yes
Please verify that you are human*
Should be Empty:

Sickle Cell Family Camp

Camper Information

Sickle Cell Diagnosis Information

Family Member Registration

Eligibility Requirements

COVID-19 Requirements

Session Selection

Sickle Cell Family Camp Dates:

Parent/Guardian Information & Emergency Contact

Emergency Contact Information

Paperwork Requirements

Paperwork Requirements to Attend

Child with Sickle Cell:

All Other Attendees: