Camp Forget-Me-Not Camper Interest Form 2025

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 interest form:

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

2. All camper interest forms will be reviewed by Alive's Grief Center staff. After submission, guardian will be asked to schedule a 30-60 minute virtual camper interview session where both the guardian and child will meet with one of our Camp Intake Counselor. Interview availability will begin in April. 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 after the camper interview session, you, your child and the intake counselor feel camp is a good fit for your child at this time, they will be approved to attend. Guardians will then 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!

3. Camp will be held August 9-10, 2025 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 on Sunday evening.

4. All campers and guardians will be required to attend our pre-camp party/orientation Sunday, August 3rd at 3:00 p.m. in at the YMCA Camp Widjiwagan.

5. Thanks to the generosity of our donors, the cost per camper is just $85.00. A $25 depost will be charged to your card within 48 hrs of submitting this form in order to secure the camper/guardian interview. After the the interview, if your camper is approved, the deposit will go toward your total camp fee. If you, your camper, or the camp intake counselor decides camp is not a good fit this year, this amount will be refunded. 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: childrensgrief@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. Permission to attend is required by both guardians.

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

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