Camp Erin-Minnesota Youth Grief Camp Application

Camp Erin-Minnesota Youth Grief Camp

Friday, June 26, 2026 | 9am-4pm, Mount Olivet Retreat Center, Farmington, MN
Thank you for registering your children for Camp Erin–Minnesota (formerly Camp Erin–Twin Cities). Camper spots are reserved on a first‑come, first‑served basis, with priority given to first‑time campers. This camp is for youth ages 6-17.

Before submitting your application, we ask that you talk with your children and/or watch the camp video together. Their desire to attend, even if they feel a little nervous, is important. We want to ensure we are saving spots for campers who truly wish to be there, especially when others may be waiting.

A phone interview with the registering parent or guardian is required before final approval. Thank you for your understanding and partnership.
- Camper Name*
  
  First NameLast Name
- Date of birth (Camp is for ages 6-17)*
  
  MonthDayYear
  Date
- YesNo
- Please note any dietary restrictions and/or food allergies:*
  If none, please note NONE
- Please note any additional medical, emotional, mental, or developmental factors that may impact your camper's time at camp:*
  Ex. medical conditions (seizures, Crohn's, migraines, etc.) or neurodiversity (autism spectrum, ADHD, etc.) or mental/emotional (anxiety, depression, etc.)
- Does your camper have any accessibility accommodations required? Please explain below.*
- YesNo
- Camper T-Shirt Size*
- YesNo
- Camper Name
  
  First NameLast Name
- Date of birth (Camp is for ages 6-17)
  
  MonthDayYear
  Date
- YesNo
- Please note any dietary restrictions and/or food allergies:
  If none, please note NONE
- Please note any additional medical, emotional, mental, or developmental factors that may impact your camper's time at camp:
  Ex. medical conditions (seizures, Crohn's, migraines, etc.) or neurodiversity (autism spectrum, ADHD, etc.) or mental/emotional (anxiety, depression, outbursts, etc.)
- Does your camper have any accessibility accommodations required? Please explain below.
- YesNo
- Camper T-Shirt Size
- YesNo
- Camper Name
  
  First NameLast Name
- Date of birth (Camp is for ages 6-17)
  
  MonthDayYear
  Date
- YesNo
- Please note any dietary restrictions and/or food allergies:
  Ex. nut allergy, lactose intolerant, cannot eat pork, etc.
- Please note any additional medical, emotional, mental, or developmental factors that may impact your camper's time at camp:
  Ex. medical conditions (seizures, Crohn's, migraines, etc.) or neurodiversity (autism spectrum, ADHD, etc.) or mental/emotional (anxiety, depression, etc.)
- Does your camper have any accessibility accommodations required? Please explain below.
- YesNo
- Camper T-Shirt Size
- YesNo
- Camper Name
  
  First NameLast Name
- Date of birth (Camp is for ages 6-17)
  
  MonthDayYear
  Date
- YesNo
- Please note any dietary restrictions and/or food allergies:
  Ex. nut allergy, lactose intolerant, cannot eat pork, etc.
- Please note any additional medical, emotional, mental, or developmental factors that may impact your camper's time at camp:
  Ex. medical conditions (seizures, Crohn's, migraines, etc.) or neurodiversity (autism spectrum, ADHD, etc.) or mental/emotional (anxiety, depression, etc.)
- Does your camper have any accessibility accommodations required? Please explain below.
- YesNo
- Camper T-Shirt Size
- African American or BlackAmerican Indian or Alaska NativeAsianHispanic or LatinoMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhiteMulti-RaceAnother race not listedPrefer not to share
- Primary Language spoken at home*
- YesNo
- Parent/Guardian*
  
  First NameLast Name
- Parent/Guardian Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent/Guardian Email*
  example@example.com
- Address (address of parent/guardian even if it is different from all children)*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Emergency Contact Name (for day of camp)*
  
  First NameLast Name
- Emergency Contact Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- The following questions are required by our national partner, Eluna Network, and used for grant funding purposes only. All information collected is confidential.
- YesNo
- If so, what branch?
- YesNo
- If so, what branch?
- Name of loved one who died*
  
  First NameLast Name
- FatherMotherStepparent/Partner of ParentGrandfatherGrandmotherUncleAuntSiblingCousin
- YesNo
- When did the death occur (date)?*
  
  MonthDayYear
  Date
- AccidentalCancerCOVID-19Heart Attack/Heart DiseaseHomicideNatural CausesAddiction relatedOverdoseMilitarySIDS or SUDCStroke/AneurysmSuicideTerminal IllnessUnknown CauseOther
- If other, please explain the cause of death:
- YesNo
- If not, please explain
- YesNo
- If not, what other death related losses has your child experienced?
- Has your child received grief counseling since your loss? If so, with what organization, and approximately how long? *
- Are there any specific concerns or information regarding your child's grief experience that would be helpful to know prior to camp?*
- Are there any changes your family is currently coping with such as illness, move, divorce, or marriage?*
- How did you learn about Camp Erin?*
- If other, please explain how you learned about Camp Erin
- Please upload a photo of your child's loved one:*
  
  Please upload a photo of your child’s loved one for an upcoming camp project. We ask that the picture be of them alone so their face is clearly visible. Your child will also bring the physical photo with them to camp. Thank you!
  Cancelof
- We strive to ensure that every child has an opportunity to participate in our programming. While we understand that schedules can change, we ask that you consider your submission a commitment as our limited capacity may require us to turn others away. We thank you for your consideration of other grieving children.
  
  As a reminder, submitting an application does not guarantee approval. Our team will discuss your application with you to determine camper readiness while answering any questions you have. We want this to be a meaningful and helpful experience for you and your children. ❤️
  
  If you have further questions, please contact: Maggie Bauer at maggie@brighterdaysgriefcenter.org
- Should be Empty: