Male Camper Registration 2026

Male Camper Registration

2026
Please review in full before continuing this application

This is the male camper registration form. If you are looking for the female form or the waitlist form, please visit our website.

Due to limited spacing this year, we are only able to accept 9 male camper and 9 female campers. We apologize for any inconvience this may cause and we are hopeful that our capacity will expand in 2027. We are accepting applications on a first come, first served basis.

Camper Elligability
- Campers must be between the ages of 7-17 at the start of camp.
- Camp will take place from July 28 - July 31. Volunteers will arrive a day early (on July 27th for training).
- This application is extensive to cover all areas of knowledge we will need in order to serve your child. If you have additional information that is not covered in the application, or questions on the application, you can email Emily@hopeshaventn.com. Emily may reach out to applicants regarding their application if further communication is required.
- Payment is required to submit your application. The following should be noted:
  - Payment is $500 for overnight campers and $125/day for day campers. Please see our website for a breakdown of this cost.
  - Financial aid is avaliable! Email Collins@hopeshaventn.com for an application. Partial and full scholarships are avaliable. If you are applying for financial aid, when it is time to submit the registration fee on this application, select "financial aid application".
    
    Please understand that your application will not accepted until payment is receieved or your financial aid application is processed.
- If your child is found to be ineligible for camp, you will receive a full refund. Eligibility determinations are typically completed within 30 days of submission.
Thank you for the trust you are placing in Hope's Haven! We can't wait to shower your children with love, adventure, and joy!

Demographics
Camper Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Has your camper previously attended summer camp?*
If yes, was this an overnight camp?
Camper's Developmental Age (This may be different than their physical age and helps us group campers with their peers:)*
Parent/Guardian Name*

First NameLast Name
Additional Parent/Guardian Name

First NameLast Name
Email*
example@example.com
Secondary Email
example@example.com
Phone Number*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Primary Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
T-Shirt Size*
If you would like your camper to be paired with a specific volunteer, list them below.
We will do our best to accommodate this
What is your camper's favorite song? We want to use this to welcome them to Hope's Haven upon their arrival!
We will pick a song for your child's arrival is none is provided here
How did you hear about Hope's Haven?

Camper Information
What are your camper's diagnoses?*
Is your camper currently enrolled in school or other consistent programs?*
Please provide the name(s) of the current or most recent school/program your camper attended*
What type of classroom is your camper in?*
Examples: full inclusion, partial inclusion, home schooled, etc.
Please list any therapies, programs, or additional services your camper participates in*
Examples: ABA therapy, occupational therapy, vocational rehabilitation, etc.
What hobbies/interests does your camper enjoy?*
Sports, hobbies, shows, special interests, etc.
Please describe any routine your camper strictly adheres by. If none, put N/A*
Please describe your camper's typical daily energy level*
What is your camper's sleep schedule, including any naps taken during the day?*

Medical Information
Height*
Weight*
Current Physician Name*
Current Physician Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Physician Phone Number
Please enter a valid phone number.
Health Insurance

This information is required in case of a medical emergency
Primary Insurance Provider*
Primary Insurance ID #*
Primary Insurance Policy Holder's Name*
Primary Insurance Policy Holder's Date of Birth*
Secondary Insurance Provider
Secondary Insurance ID #
Secondary Insurance Policy Holder's Name
Secondary Insurance Policy Holder's Date of Birth
Has your camper had a seizure within the last 6 months?*
If yes, what did this look like?
Please note that if your child has had a seizure within the last 6 months that they we will require medical clearance from a physician before camp. This form will be provided to you via email after your child's application is approved.
Please provide any additional information about your camper's health including use of a catheter, heart monitor, CPAP machine, or any other medical device.
Does your child have bowel issues?*
If yes, please explain and provide information on what help alleviate the issue
Allergies
Does your camper have a bee or a wasp sting allergy? *
Does your camper have any drug allergies? *
If yes, please list drug allergies
If yes, please list other allergies
Does your camper have any food allergies?*
Please list your camper's food allergies.
Does your camper have any other allergies?*
If yes, please explain
Dietary Needs
Is your camper on a specific diet?*
Please provide details about your camper's dietary needs.
Please provide any other information about your camper's dietary needs or meal time routines, including use of assistive feeding devices. If your camper eats a limited variety of foods (ie: only eats chicken nuggets,) you may be asked to provide food to be prepared for your camper. Please note here if you would like to discuss your camper's food needs further and a member of leadership will reach out to you.
Do you have any additional information you would like to share with our nurses?
Medication

Please be as detailed here as possible. You will receive an email confirming medication has not changed prior to your arrival at camp. Upon arrival at camp, nurses will review this with you a final time to ensure accurate dispensing of medication.

Finalization

Signing below indicates that all of the above information is reported accurately and completed to the best of your knowledge.
Legal Guardian Signature

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My Products*

Overnight Camper Registration

$500.00 Quantity

Day Camper Registration Please enter the quantity as the number of days your child will attend. Details of days, and pick-up and drop-off times can be determined via email.

$125.00 Quantity

Financial Aid ApplicationOnly select if you wish to apply for financial aid. Your child is not registered until your financial aid application has been processed. Email Collins@hopeshaventn.com for an application.

$ Free

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

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Male Camper Registration

Demographics

Camper Information

Activities of Daily Living

Medical Information

Health Insurance

Allergies

Dietary Needs

Medication

Behavioral Health

Communication

Sensory Needs

Finalization