Camp HLC Family Application

Camp HLC Family Application
Camp Selection
What camp are you applying to?*

Parent/Guardian 1
First Name *
Last Name*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Mobile Phone*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
T-Shirt Size
Need ADA Cabin:
Dietary Restrictions/Allergies
Relationship to Camper
Parent/Guardian 2
First Name
Last Name
Date of Birth

MonthDayYear
Date
Email
example@example.com
Mobile Phone
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
T-Shirt Size
Need ADA Cabin:
Dietary Restrictions/Allergies
Relationship to Camper
Communication Consent:
I agree and give consent to receive text messages.I do not agree to receive text messages.
I agree and give consent to receive email updates

ALS Journey
Name*
pALS
Relationship to Camper(s)*
Still living?*
Date of passing:

MonthDayYear
Date
Briefly share your ALS journey:*
How are they doing?

Hope Loves Company – Behavior Standards Agreement
Camp HLC is a family-centered weekend designed to create connection, compassion, and community. To ensure a safe, welcoming, and fun experience for everyone, I understand and agree that:

Respect & Kindness:
-I will treat all campers, families, volunteers, and staff with respect and kindness. My words and actions will support a positive, inclusive atmosphere for everyone.
Safety & Conduct:
-I will follow all camp rules, including those of the host campsite. I understand that smoking, alcohol, drugs, and weapons are not permitted. I agree to help keep camp a safe space, both emotionally and physically.
Behavior & Participation:
-I will behave in ways that reflect the values of Hope Loves Company. If my behavior or my child’s behavior disrupts the safety or spirit of camp, we may be asked to leave.
Dress & Representation:
-I will wear clothing that is comfortable, modest, and appropriate for a family camp setting. I understand that I represent the HLC community through my attitude and participation.
Hope Loves Company – Privacy, Safety & Social Responsibility Agreement
To ensure every camper and family enjoys a safe and supportive environment, I understand and agree that:

Privacy & Confidentiality:
-I will respect the privacy of all campers, families, and staff. Personal or sensitive information shared during camp is confidential and not to be shared outside the program.
Child Safety:
-Hope Loves Company maintains a zero-tolerance policy for abuse, neglect, or inappropriate behavior. Campers are always supervised, and concerns will be reported immediately to camp leadership.
Social Media & Representation:
-I will not post or share any photos, videos, or details about other campers or families online without permission. I understand that social media content connected to Hope Loves Company should reflect kindness, respect, and the values of our community.
Hope Loves Company – Waiver, Release & Media Agreement
Camp HLC is a place for connection, hope, and fun. To keep everyone safe and to share our story responsibly, I understand and agree that:

Participation & Liability
-I am physically and emotionally able to take part in camp activities.
-I release and hold harmless Hope Loves Company®, Inc., its staff, volunteers, and partners from any injury, loss, or damage that may occur while participating in Camp HLC activities or while traveling to and from camp.
-I accept full responsibility for my own safety and that of my child during participation.

Medical Care
-In case of illness or injury, I authorize Hope Loves Company staff or emergency personnel to provide or arrange medical care as needed.
-I agree to cover any costs related to such care, including transport or emergency services.

Photo & Video Use
-I give Hope Loves Company permission to photograph or record me (and/or my child) during camp and to use those images, videos, or recordings for the purpose of promoting the mission of Hope Loves Company.
-I understand that I will not receive payment for participation in any photos or videos, and I waive the right to review or approve materials before they are used.
-Hope Loves Company respects all families and uses photos and videos only to share positive, respectful stories about our community.
Yes, my family may be photographed and recorded for Hope Loves Company useYes, with restrictions (please specify below)No, I prefer my family not be photographed or recorded
Please describe your photo/video restrictions:
Acknowledgment & Signature
By signing your name below, I confirm that I have read and agree to the Hope Loves Company Behavior Standards Agreement, the Privacy, Safety & Social Responsibility Agreement, and the Waiver, Release & Media Agreement as stated above. I understand that full copies of all HLC policies are available upon request by contacting the Programs team at 609-570-4547.
Printed Name*
Date*

MonthDayYear
Date
Should be Empty:

Camp HLC Family Application

Camp Selection

Parent/Guardian 1

Parent/Guardian 2

Communication Consent:

Family Details

ALS Journey

Camp History and Transportation

Camp Transportation

Hope Loves Company – Behavior Standards Agreement

Hope Loves Company – Privacy, Safety & Social Responsibility Agreement

Hope Loves Company – Waiver, Release & Media Agreement

Acknowledgment & Signature