Summer of Strength Sickle Cell Warrior Camp Interest Form

Summer of Strength Sickle Cell Warrior Camp Interest Form

Please complete the registration form by providing student and parent information, medical details, and emergency contact information. This program is proudly sponsored by Travail With Us. Once your form has been submitted, our office will contact you to confirm enrollment and provide additional program details.
Student Full Name

First NameLast Name
Student Grade (K-8)
Student Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Medical Information (including sickle cell details, allergies, medications, or special needs)
Emergency Contact Full Name

First NameLast Name
Emergency Contact Relationship to Student
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pick Up List (ID must be provided)
Free Registration
prevnext( X )
Summer of Strength Sickle Cell Warrior Summer Camp
This summer mentoring and enrichment program is designed specifically for students living with sickle cell disease. Students will participate in mentoring sessions, academic support, wellness discussions, and fun interactive enrichment activities in a safe and encouraging environment. The program will meet once a week on every Tuesday during the month of July and will include breakfast, lunch, transportation support, and an end-of-program field trip celebration.

Free Quantity

Total

$0.00
Should be Empty:

Summer of Strength Sickle Cell Warrior Camp Interest Form

Free Registration*

Free Registration