DAY CAMP 2027

Day Camp Session Cost: $225 for one week or $350 for two weeks.

Session ONE (June 14-18, 2027) payment can be made here.

Session TWO (June 21-25, 2027) payment can be made here.

Your child's spot is not secure without this payment, and day camp spots are limited!

TENNESSEE CAMP FOR DIABETIC CHILDREN

How did you hear about TCDC?

Full Legal Name of Camper

Camper's Preferred Name

Name of Parent(s) or Guardian(s)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Camper Birth Date

Date

Age at Diagnosis

Name of Insulin(s) Used

Will Camper Be On Insulin Pump?

If yes, what is the brand?

Carb Ratio

Continuous Glucose Monitor Name

We provide lunch. Please check the box if your child has any of the following dietary restrictions.

What size t-shirt does your camper need?

PRIMARY CARE DOCTOR

Address of Primary Care Doctor

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number for Primary Care Doctor

Please enter a valid phone number.Format: (000) 000-0000.

DIABETES DOCTOR (if different)

Address of Diabetes Doctor

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number for Diabetes Doctor

Please enter a valid phone number.Format: (000) 000-0000.

We post about camp daily. Do you give permission for your child to appear on our social media accounts, website, or other publication?

Please upload a recent (less than six months ago) picture of your child's face to accompany this application.

I wish to enroll the above-named child as a member of the Tennessee Camp for Diabetic Children for the day camping period. I understand that participating in TCDC activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I also understand that participating in these activities is entirely voluntary and requires participants to abide by all applicable rules and standards of conduct established by TCDC. I have carefully considered the risks involved and give consent for the above-named child to participate in all TCDC camp activities. I release TCDC and all employees, volunteers, related parties, or other organizations associated with TCDC, from any and all claims or liability arising out of this participation.

Signature of Parent or Guardian