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2025 Camp HLC Application 

2025 Camp HLC Application 

Camp HLC is a free weekend retreat for children, teens, and families affected by ALS or Lou Gehrig's disease. It's a wonderful opportunity for families affected by ALS to come together to connect with peers who share in their experiences, enjoy recreational activities, and create long-lasting memories and connections. Please know that the entire family is invited to camp and people living with ALS join in the fun. Camp HLC takes place on campgrounds that are accessible, but please contact us so that we can best meet the needs of your family. If you have any questions, or would like to learn more about the Camp HLC experience, please contact our office at 609-730-1144.
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    • Georgia: Twin Lake YMCA September 26-28th (Winder,GA)
    • California: Apple Canyon Center November 21-23 (Mountain Center, CA)
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    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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  • 3
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    • Please Select
    • Mother
    • Father
    • Grandmother
    • Grandfather
    • Sister
    • Brother
    • Aunt
    • Uncle
    • Other
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    • Please Select
    • Male
    • Female
    • Agender
    • Gender Nonconforming
    • Nonbinary
    • Prefer not to answer
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    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
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    Next
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  • 9
    Please Select
    • Please Select
    • Mother
    • Father
    • Grandmother
    • Grandfather
    • Sister
    • Brother
    • Aunt
    • Uncle
    • Other
    Please Select
    • Please Select
    • Male
    • Female
    • Agender
    • Gender Nonconforming
    • Nonbinary
    • Prefer not to answer
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  • 10
    Please Select
    • Please Select
    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
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  • 11
    Please provide information of a trusted adult not attending camp.
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    This does not disqualify you from receiving free services from HLC. This information is used for funding/grant purposes only, to help us serve even more families affected by ALS
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  • 13
    Please Select
    • Please Select
    • Yes
    • No
    • No, saw pALS weekly
    Please Select
    • Please Select
    • Yes
    • No
    • Bathing and grooming
    • Laundry and helping with dressing
    • Food shopping
    • Preparing meals and feeding
    • Light housekeeping
    • Managing medications
    • Transportation
    • Mobility assistance
    • Companionship and emotional support
    • Communicating with doctors and monitoring medications
    • Assisting with siblings task
    • None of these above-please explain in "other advice" space provided
    • Camper does not take part in any caregiving task
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  • 14
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  • 15
    Please explain how your pALS is currently doing.
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    -
    Pick a Date
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    This question is optional. However, it will help us with grant information to help more kids and families affected by ALS.
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    • Male
    • Female
    • Agender
    • Gender Nonconforming
    • Nonbinary
    • Prefer not to answer
    Please Select
    • Please Select
    • He/Him
    • She/Her
    • They/Them
    Please Select
    • Please Select
    • Adventures: Ages 6-9
    • Hikers: Ages 10-12
    • Guides: Ages 13-21
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    • Please Select
    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
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  • 20
    If there are no restrictions or allergies to provide, please write "N/A".
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    (For example: values, confidence, social/emotional skills, friendship, etc…)
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  • 24
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    The photo should include just your child and be clear and close-up.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
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    Please Select
    • Please Select
    • Male
    • Female
    • Agender
    • Gender Nonconforming
    • Nonbinary
    • Prefer not to answer
    Please Select
    • Please Select
    • He/Him
    • She/Her
    • They/Them
    Please Select
    • Please Select
    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
    Please Select
    • Please Select
    • Adventures: Ages 6-9
    • Hikers: Ages 10-12
    • Guides: Ages 13-21
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  • 28
    Please Select
    • Please Select
    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
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  • 29
    If there are no restrictions or allergies to provide, please write "N/A".
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  • 30
    • Huge
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    quoteCreated with Sketch.
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    • Huge
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    (For example: values, confidence, social/emotional skills, friendship, etc…)
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    • Normal
    • Small
    Ok
    quoteCreated with Sketch.
    Ok
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  • 33
    Press
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  • 34
    The photo should include just your child and be clear and close-up.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
    Press
    Enter
  • 35
    Press
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  • 36
    Please Select
    • Please Select
    • Male
    • Female
    • Agender
    • Gender Nonconforming
    • Nonbinary
    • Prefer not to answer
    Please Select
    • Please Select
    • He/Him
    • She/Her
    • They/Them
    Please Select
    • Please Select
    • Adventures: Ages 6-9
    • Hikers: Ages 10-12
    • Guides: Ages 13-21
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  • 37
    Please Select
    • Please Select
    • Youth Small
    • Youth Medium
    • Youth Large
    • Adult Small
    • Adult Medium
    • Adult Large
    • Adult Extra Large
    • Adult XXL
    • Adult XXXL
    Press
    Enter
  • 38
    If there are no restrictions or allergies to provide, please write "N/A".
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  • 39
    • Huge
    • Large
    • Normal
    • Small
    Ok
    quoteCreated with Sketch.
    Ok
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    • Huge
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    (For example: values, confidence, social/emotional skills, friendship, etc…)
    • Huge
    • Large
    • Normal
    • Small
    Ok
    quoteCreated with Sketch.
    Ok
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  • 42
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  • 43
    The photo should include just your child and be clear and close-up.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
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  • 44
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  • 45
    Person other than parent/guardian authorized to drop off and/or pick up child. No one will be permitted to pick up your child if their name is not listed here. All persons must have and show their picture ID. This requirement is necessary to account for all campers and to keep them safe.
    Please Select
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    • Grandparent
    • Relative
    • Family Friend
    • Other-Please text relationship in the next box
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  • 46
    There is travel assistance to Camp HLC for children and families who have difficulty getting to camp due to financial restrictions, and/or Camp HLC is unavailable within their geographical area. Travel assistance “awards” and amounts will be reviewed and disbursed on a case-by-case basis. Families accepted for travel reimbursement will be responsible for arranging their travel accommodation. Are you interested?
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  • 47
    Please read the following document.
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  • 53
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  • 54
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  • 55
    Please list the name all the participants who will be attending camp. These names will be in reference Hope Loves Company, Inc.’s policy on Confidentiality, Sexual Abuse and Procedures, and Waiver & Release Agreement presented above.
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  • 56
    I, the undersigned, acknowledge that I have completely read and fully understand the Hope Loves Company, Inc.’s policy on confidentiality and the Statement of Confidentiality, sexual abuse and the Sexual Abuse Policy and Procedures, and Waiver &Release Agreement presented above. I agree that my signature below is acknowledgement to abide by the requirements of policy and agreements.
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  • 57
    -
    Pick a Date
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  • 58
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2024 Camp HLC Application 
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