Camp Good Grief

Camp Good Grief

Camper Registration - March 20-22, 2026
A counselor's assessment of each camper is required prior to participation. Campers may only attend camp once.
CAMPER INFORMATION
Camper Name*

First NameLast Name
Camper Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Camper Age*
Camper Gender*
Camper Grade*
Parent Information
Parent/Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Secondary Adult Contact Name*

First NameLast Name
Secondary Adult Phone Number*

Area CodePhone Number
Treasure Coast Hospice Grief Support has planned for a safe and fun camp experience. All activities are supervised by counselors and administrative staff. All staff and volunteers have participated in a specialized training in children's grief, camp goals, rules and safety, and have obtained background checks through the Florida Department of Law Enforcement, the Dru Sjodin National Sex Offenders Website, and www.floridasexoffender.net.
Medical History & Consent
YesNo
1) If yes, please explain.
YesNo
If yes, please explain.
YesNo
If yes, please explain.
YesNo
YesNo
YesNo
YSYMYL/ASAMALAXLA2XL
YesNo
Parents/Guardians are expected to provide transportation to and from 12100 Seminole Pratt Whitney Rd, West Palm Beach, FL 33412.

To reserve your space, please e-sign the Liability Release below along with payment information. This completed application and payment must be submitted before March 6th, 2026.

Spots are limited. Registration is treated on a first come, first served basis.
LIABILITY RELEASE
I agree that Treasure Coast Hospice, its Board of Directors, Officers, Employees, and Volunteers are released from any legal responsibility and/or liability of negligence arising out of any accidental injuries or illnesses which occur while my child is attending Camp Good Grief.*
First M. Last
Date*

MonthDayYear
Date
My Products*
prevnext( X )
Camp Good Grief$25.00
$25.00 per camper.

Total $0.00
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