Welcome to the Myra's Kids Foundation – Camp 2026 Application & Registration Process!
No child should grieve alone.
We are thrilled to invite you to join us for an unforgettable camp experience at Myra’s Kids Foundation – Camp 2026! We understand that grief is a deeply personal journey, and our camp is designed to provide a safe and supportive space where children and youth can connect, heal, and grow.
Family Last Name
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Email
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example@example.com
How did you hear about Myra's Kids Foundation?
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We hope that you find this process smooth and straightforward, but if you have any questions or run into challenges, please don’t hesitate to contact us - info@myraskids.ca. The information you provide will help us create the best possible environment for your child(ren) at camp, supporting them as they navigate their grief and build resilience for the future.
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Key Dates for MKF Summer Camp 2026
Campers Meet & Greet: Sunday, August 9, 2026, 2:00–4:00 p.m. This event will either be held in person at TBD location (to be confirmed closer to the date). Campers will have the opportunity to connect with peers and volunteers during the meet and greet, while caregivers attend an information session designed to address questions, concerns, and ensure a smooth transition.
Camp Program
Camp dates: Thursday, August 13 – Sunday, August 16, 2026 Caregivers will drop off campers at the designated location - Burger King Decarie 5300 Rue Jean-Talon O, Montréal, QC H4P 2T5 at 8:00 a.m. and may be asked to participate in a brief health screening. The camp will conclude with a Closing Ceremony on Sunday, August 16, 2026, at approximately 2:00 p.m. (location TBD). Camp Reunion: Stay tuned for details about our Camp Reunion!
Applications must be completed in full to be considered. After submission, our team will contact you to schedule a mandatory intake interview. If we are unable to reach you after three attempts, we encourage you to contact us to complete the process. Please note that this intake is required for your child to attend MKF Camp 2026. Acceptance to camp is contingent upon both the interview and attendance at the meet and greet on August 9, 2026. At Myra’s Kids Foundation, we are committed to providing bereaved children and youth with the support and care they need to heal, grow, and thrive. We understand that discussing loss can be difficult, and our team is here to help your family navigate this process. If you have any concerns or would like support, please reach out to us at corrie@myraskids.ca or discuss it during your intake interview.
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I Agree
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Key Details for Camp 2026
By registering for MKF Summer 2026, I understand that Camper Meet & Greet on Sunday, August 9, 2025 from 2:00–4:00 p.m is mandatory.
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Agree
I understand that camp dates are Thursday, August 13 - Sunday, August 16, 2026
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Agree
I understand that the camp program is offered in English. Notez que le programme est offert en anglais.
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Agree
I understand that acceptance to camp is contingent upon both the interview AND attendance at the meet and greet on August 9, 2026
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Agree
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Camper Information
Please Note that if there are multiple siblings per family, one application must be submitted per child.
Family Name / Nom de famille
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Camper Full Name
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First Name
Last Name
At camp, every child wears a lanyard. Please tell us the name your child prefers to be called so we can print it correctly.
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Please Upload a clear Photo of your Camper (can be emailed later in the application process)
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Camper Birthday (DD/MM/YY)
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Campers Age at Camp (Aug. 13, 2026)
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Please Select
6
7
8
9
10
11
12
13
14
15
16
17
18
19
Preferred Pronouns
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Please Select
She/Her
He/Him
They/Them
Other / Self-Describe [Text box appears if selected]
Prefer Not to Say
Is your child a returning camper?
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Please Select
Yes
No
School Name
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School Board
Current Grade
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Please Select
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
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Parent / Guardian Information
Parent/Guardian #1 Name
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First Name
Last Name
Parent/Guardian #1 Phone Number
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Please enter a valid phone number.
Parent/Guardian #1 Email Address
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example@example.com
Parent/Guardian #1 Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian #2 Name
First Name
Last Name
Parent/Guardian #2 Phone Number
Please enter a valid phone number.
Parent/Guardian #2 Email Address
example@example.com
Parent/Guardian #2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
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First Name
Last Name
Emergency Contact Phone Number
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Please enter a valid phone number.
Relationship to Camper
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Are there any custody/access restrictions we should be aware of?
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Yes
No
Other
In the event of an emergency, if no parent, guardian, or designated emergency contact can be reached, I authorize MKF leadership to make any necessary decisions on my/our behalf.
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Agree
Languages Spoken
English
French
Other
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Demographic Information
(Required for funding and reporting purposes. All responses are confidential)
How would you describe your family’s racial/ethnic background?
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Indigenous (e.g., First Nations, Inuit, Métis)
Asian (e.g., East Asian, South Asian, Southeast Asian)
Black / African Descent
Hispanic / Latin American
Middle Eastern / North African
White / Caucasian
Multiracial / Mixed Heritage
Prefer Not to Say
Other
How many adults currently live in your household?
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How many children currently live in your household?
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What is your combined family income?
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Please Select
Under $30,000
$30,000–$49,999
$50,000–$74,999
$75,000–$99,999
$100,000–$149,999
$150,000–$199,999
$200,000 or above
Prefer Not to Say
(Asking only for reporting purposes, we reiterate, all programs for Myra's Kids are offered Free of Charge)
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Camper Experience and Preferences
T-Shirt Size
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Please Select
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Dietary Restrictions
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None / No Dietary Restrictions
Vegetarian
Vegan
Gluten-Free
Dairy-Free / Lactose Intolerant
Nut Allergy / Tree Nut Allergy - Carries Epipen
Nut Allergy / Tree Nut Allergy - No Epipen
Shellfish/Seafood Allergy
Halal
Kosher
Other
Is your child comfortable around water
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Please Select
Yes
No
What is their swimming ability?
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Please Select
Non-Swimmer
Beginner (Requires close supervision)
Intermediate (Comfortable in shallow/deep water)
Advanced (Strong swimmer in various conditions)
Is there anything about your child’s swimming ability that we should know?
What are your camper’s favourite activities or hobbies?
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Does your camper have any fears or anxieties we should be aware of?
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Medical and Dietary Information
Medicare Number
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Upload a photo of your Childs medicare card (can be sent once application is completed)
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Family Physician Name
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Family Physician Office Name
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Family Physician Phone Number
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Please enter a valid phone number.
Does your child carry an epi-pen?
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Please Select
Yes
No
*If you selected yes, you will need to send 2 epi-pens with your child to camp*
Does your child have any allergies
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No Known Allergies
Yes – Please Specify
If you selected “Yes,” please share any important details about your child’s allergy here.
Does your child have any medication for specific allergies?
Do any allergies cause anaphylaxis risk?
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Please Select
Yes – At risk for anaphylaxis
No – Not at risk for anaphylaxis
Unsure / Unknown
Are your camper’s immunizations fully up to date?
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Yes, fully up-to-date
No, not fully up-to-date
Unsure
Does your camper have a history of sleepwalking?
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Please Select
Yes
No
Unsure
Does your camper have a history of bedwetting?
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Please Select
Yes
No
Unsure
Medical History
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*Please let us know below if your child has any medical conditions such as asthma, breathing problems, skin conditions, frequent or recurrent infections (UTI, ear infections), digestion problems, sports injuries, heart conditions, epilepsy, migraines, diabetes, bleeding problems (nose bleeds), vision difficulties, hearing difficulties, any other issue your child is followed regularly by a medical professional etc.
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Mental Health Profile Social & Emotional Needs
Mental Health/Behaviors
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(Please list if your child has any mental health or behavioral concerns, including anxiety, depression, ADD/ADHD, etc.)
Do you or your child currently receive psychological or social work support?
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Please Select
Neither of us receive support
I receive support
My child receives support
Both of us receive support
N/A
If yes, please provide the following details: Name of the professional(s), Type of support provided, Frequency of sessions, Duration of support to date, Contact information for the professional(s), Any specific strategies, recommendations, or concerns shared by the professional that we should be aware of to better support your child and anything else relevant to this subject that might help us.
In an effort to support your child best, can we have consent to contact them
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Please Select
N/A
Yes
Contact me for more information
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Behavioural Information
Are your camper’s social skills similar to those of their peers?
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Yes, similar to their peers
Somewhat less developed than peers
Somewhat more advanced than peers
Unsure / Not sure
Does your camper have any challenges with learning, understanding instructions, or remembering information?
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Please Select
Yes
No
Does your child have any sensory sensitivities (e.g., to noise, touch, or lights)?
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Please Select
No Sensitivities
Yes – Please Specify (selecting this option can trigger a text field for details)
Unsure / Not Sure
Does your camper have any behavioural challenges?
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No – My camper does not have behavioural challenges.
Yes – My camper experiences behavioural challenges (please specify if possible below).
Unsure / Not sure.
Wrote "Yes" above
Does your child have a history of, or present suicidal ideation?
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Please Select
Yes
No
Dont Know
If yes, please expand.
Does your child have a history or present self-harm behaviors?
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Please Select
Yes
No
Dont Know
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Grief and Bereavement Context
Death and Loss Information
Please tell us what death(s) your child has experienced
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What was their relationship to the child?
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Parent / Legal Guardian
Grandparent
Aunt / Uncle
Sibling
Other Family Member
Other
Did the child live with the person who died?
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Please Select
Yes
No
How would you describe the child’s relationship with the deceased?
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Date of Death
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-
Month
-
Day
Year
Date
Cause of death
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Age of person who died
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Age of camper when their person died
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Please Select
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Does your child know the cause of death?
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Please Select
Yes
No
Is there anything else you think it would be helpful for us to know about your child?
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Photo, Publicity, and Liability Waiver
By participating in Myra’s Kids Foundation Camp 2026, you acknowledge and agree that photos, videos may be taken and that content may be created during camp activities for use in promotional materials, publications, and social media. These images will be used to celebrate and share the magic of camp while maintaining sensitivity to our campers’ privacy. Should you have any concerns regarding this, please indicate so during the intake process.
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Agree
To better understand who benefits from our services, we are collecting demographic data about our campers’ families, as requested by our funders. This information will remain confidential and only be accessible to MKF Camp administrators. We may share aggregated, anonymous summaries with funders (e.g., “xx% of campers experienced the death of a father”) to protect privacy. Rest assured, no personal information will be disclosed, and your access to services will not be affected by your responses.
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Agree
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Parental Consent
I acknowledge that filling out this application is the first step in our process and does not ensure admission into the program. A Myra’s Kids Foundation representative will be in touch to schedule an interview shortly after receiving this application.
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Please Select
Accept
I understand that should my child or I experience a significant personal loss or any major life change after submitting this application, I will promptly update the Myra’s Kids Foundation team.
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Agree
Name of Guardian Signing the Application
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First Name
Last Name
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