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  • CAMP CRESCENT MOON APPLICATION 2023

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  • Camp Crescent Moon is for children ages 7-14 with SICKLE CELL DISEASE

  • APPLICATION DUE DATE:  THURSDAY, JUNE 1st

    ** APPLICATION MUST BE FILLED OUT AND SUBMITTED ONLINE ** 

    DO NOT PRINT THIS APPLICATION

     

    COVID-19 Safety and Vaccination Requirements: 

    Proof of Covid-19 Vaccination is required to apply!

    Proof of COVID-19 vaccination is required for ALL campers and must be submitted with this application. 

    Unfortunately, if your child has not started the Covid-19 vaccination series by March 1, 2023, they will not be eligible to attend camp due to the vaccination schedule and the inability to complete the primary covid-19 vaccination by the start of camp.

    See Covid-19 Vaccination Timing Schedule - Schedule if Moderately or Serverly compromised (page 2)

  • Health History/Physical Due by June 1st:

    Please call your child's doctor as soon as possible to schedule a physical exam. The information we need must be current. We will request an update on your child's health status from his/her doctor before camp.

  • NEED HELP??

    IF YOU HAVE QUESTIONS about this application, about required paperwork, or need further assistance, please contact the Sickle Cell Disease Foundation at 909-743-5226 or send an email to camps@scdfc.org.

  • Estimated time to fill out the application: 

    The application will take about 20 minutes. Please fill out ENTIRELY. One application per child. Fill out and submit ONLINE ONLY. **DO NOT PRINT AND SCAN.**

    If you do not have Internet access - please find someone to help you fill this out online. If you're worried about your computer crashing or the app not going through, save answers as you go along in a Word Document and copy and paste them into the application.

    You can also email us at camps@scdfc.org if you need help with the application. 

  • ITEMS TO UPLOAD AT THE END OF THE APPLICATION:

    1. COVID-19 Vaccination Card
    2. CURRENT PHOTO: Please upload a current JPG photo of this child at the end of the app. 
    3. MEDICAL INSURANCE CARD: Please upload a copy of your child's insurance card at the end of the app.
  • REGISTRATION FEE - $50:

    Deposit of $10.00 - Due by June 15, 2023

    Balance of $40.00 - Due by July 15, 2023

    You may pay with cash, check, debit/credit card, PayPal, or money order.

    CHECKS AND MONEY ORDERS SHOULD BE MADE OUT TO:

    Sickle Cell Disease Foundation.

    Mail to: SCDF Camp Crescent Moon, 3602 Inland Empire Blvd., Suite C315, Ontario, CA 91764

    Waiver Program available: Please email camps@scdfc.org

  • Child's Information



  • Parent/Guardian Information



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  • Emergency Contact Information

    I authorize the following persons to be contacted and give my permission to turn my child over to these individuals if for any reason my child has to leave camp and I CANNOT BE REACHED (please do not list yourself).
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  • Medical Insurance & Doctor Information

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  • Camper Information

    Please fill this out to the best of your ability. We want to make sure your child has a safe, healthy, fun time at camp. This information is extremely helpful!





  • For girls/children assigned Female at birth ONLY:

  • HISTORY/STORY: Please share your child's history or story so we can understand how to give them an even MORE amazing week at camp!

    Please be as honest as you can

  • Please download the Emergency Treatment Release Form, Teacher Questionnaire and Health History/Physical BELOW. 

    There are six pages. Your child's teacher must complete the teacher questionnaire, and your child's doctor/nurse must complete the physical.

    Be sure to send all back with ORIGINAL signatures by June 1st.  

    Please mail to

    SCDF Camp Crescent Moon,

    3602 Inland Empire Blvd., Suite C315, Ontario, CA 91764.

    You can also fax the forms to (909) 743-5227.

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