Camp Forget-Me-Not Camper Application 2023

Thank you for your interest in Camp Forget-Me-Not. Our camp provides a truly unique experience which allows for the fun of traditional camp activities like swimming, zip-lines, arts and crafts, sports and games, while being infused with grief education, memorialization and support. Please review the following information prior to completing the application:

1. Camp Forget-Me-Not is for children and teens ages 8-17 who have experienced the death of someone significant.

2. All camper applications will be reviewed by Alive's Grief Center staff. Guardians will be contacted to schedule a 15-30 minute virtual orientation session with our Camp Intake Counselor. This provides a one-on-one opportunity for us to discuss your family's loss in more detail, learn more about your camper's needs and cover any questions about camp that you might have. If your camper is approved, guardians will receive a welcome letter and additional documents to complete via email. Applications are considered on a first-come-first-serve basis, and space is extremely limited, so register early!

4. Camp will be held August 12-13, 2023 at the fabulous YMCA Camp Widjiwagan located just 20 minutes east of downtown Nashville. Campers will arrive Saturday morning and stay overnight. Closing ceremony will be held at on Sunday evening.

5. All campers and guardians will also attend our pre-camp party/orientation Sunday, August 6th at 3:30 p.m. in at the YMCA Camp Widjiwagan.

6. Thanks to the generosity of our donors, the cost per camper is just $85.00. A $25.00 deposit, due by 6/24/23, will secure your camper's reservation. The remaining balance is due by 7/29/23. Scholarships and payment plans are available based on need and can be discussed during your camper orientation session.

Please contact us if you have any questions: 615-963-4732 or email: griefsupport@alivehospice.org

About You

Your name *

Your relationship to the camper you are registering *

Your email address *

House Number and Street Name *

City *

State *

Zip Code *

Your Phone number *

How did you hear about Camp Forget-Me-Not? *

Guardian Status *

Attach parenting plan, if applicable

How did you hear about camp? *

Demographic Information

The majority of camp funds have been generously donated through grants, foundations, individual, and corporate donations. To ensure future funding for the program, camper demographic information is required and will be used ONLY for the purpose outlined by grant requirements and for use when writing other grants to seek funding for the program.

Approximate Gross Household Income *

# of people living in household *

Race/Ethnicity *

If other, please describe:

Is either guardian an active, reserve, national guard military member or military veteran? *

Yes

No

Was the deceased an active, reserve, national guard military member or military veteran? *

Yes

No

Married	Widowed
Divorced, Joint Custody	Divorced, Sole Custody
Legal Temporary Guardian	Other