Family Retreat Registration Form 2022

Thank you for your interest in Family Retreat. During this special event, families come together to play, remember, share, and connect. The day will include a variety of recreational activities, art and crafts, woodworking, and memory making that will strengthen your family bond in the midst of grief.
Please review the following information prior to completing the application:
 
1. Family Retreat is for families with children under the age of 18, who have experienced the death of someone significant.
 
2. Family Retreat will be held October 8, 2022 at the fabulous YMCA Camp Widjiwagan located just 20 minutes east of downtown Nashville. Families will arrive 10:00 am Saturday and finish at 7:00 p.m. Lunch, dinner, and snacks will be included.
 
3. Thanks to the generosity of our donors, the cost per family is just $50.00. The balance is due by 9/25/22. A limited number of scholarships are available based on need and can be discussed during your virtual orientation session.
 
Please contact us if you have any questions: 615-963-4732 or email: griefsupport@alivehospice.org
 

About You

The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another adult participant to add? *
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another adult participant to add? *
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another adult participant to add? *
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *

About Your Child

 +
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another child you would like to register? *
 +
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another child you would like to register? *
 +
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *
Do you have another child you would like to register? *
 +
The following 6 over-the-counter (OTC) medications are available at Family Retreat. Please check the medications the retreat nurse can give participant. Please keep unchecked those medications that may not be given. *