Family Journey Camp Out Application

Family Journey Campout Application

To be filled in by Parent/Guardian, you will be considered the “primary contact” for all people in your family. If you need help filling out this application, please reach out to us at 360-358-3213 (call/text) or info@wildgrief.org.
Primary Contact Name*

First NameLast Name
Primary Contact Preferred Name
Primary Contact Pronouns
Primary Contact Email*
Primary Contact Mobile Phone*
Best Other Phone
Primary Contact's Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list all additional adults that will be attending.
Please list all children that will be attending.*
Is there anything you would like us to know about your family structure?
Which Family Camp weekends are you available for?*

Saturday, June 22nd-Monday June 24th, 2024Saturday, July 13th-Monday July 15th, 2024Either one
If you are available for both, do you have a preferred trip?

Saturday, June 22nd-Monday June 24th, 2024Saturday, July 13th-Monday July 15th, 2024
Below are questions about the death and how your family is doing. These questions will help us provide the best experience for your family. There are no right or wrong answers, please be as honest as you can. This information is confidential and will not be shared outside of Wild Grief. We will be sharing it with the guides on your trip.
Who died, how did they die, and what was their relationship to you and your children?*
When did the death(s) occur? (approximate Month/Year)
What is challenging for you and your children in your grief process?*
What attracts you and your children to this program and what do you hope to get out of it?*
What, if any, other grief support have members of your family done? (Example: Counselor, Peer Grief Support Group, other camps (Camp Erin), clergy, talk honestly with you, etc)*
What, if any, concerns do you have about this program?*
Please share anything you’d like us to know about any personal identities and how we can help you and your family feel supported.
Anything else you would like to share about your family?*
Below are questions about the death and how your family is doing. These questions will help us provide the best experience for your family. There are no right or wrong answers, please be as honest as you can. This information is confidential and will not be shared outside of Wild Grief. We will be sharing it with the guides on your trip.
If you live in Washington State, what county do you live in?
What is the primary language spoken at home?
How did you first hear about us?*

CounselorWeb SearchFacebookInstagramOther Grief GroupPast ParticipantFriendFamilyChurchSchoolOther
Race/Ethnicity of Participants*
Gender Identity of Participants*
Household Income*

< $30,000$30,000-$50,000$50,000-$80,000> $80,000Decline to answer
Do your children qualify for free/reduced lunch at school?

YesNoI'm not sureDecline to answerOther
Do you or any of your children identify as having a disability?

YesNoDecline to answer
If yes, is there anything you'd like to share about you or your child's disability and how we can make our programs more accessible to you?*
Thank you for applying to join us in our Family Journey Campout. We consider a variety of factors in filling our trips and we will begin review April 15th 2024. You should expect to hear back from us shortly after. Please reach out with any questions at info@wildgrief.org or call/text 360-358-3213.
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Family Journey Campout Application