Camp Erin Camper Application Form

  • Camp Erin Camper Application Form

  • Camp will be held from Friday, July 10th – Sunday, July 12th, 2026 at Camp Lutherhaven, Coeur d'Alene, ID.

    The Willow Center will be hosting Camp Erin which is a transformational weekend camp specifically designed for kids and teens, ages 6-17, who have experienced the death of a significant person.

    Camp Erin combines traditional, fun camp activities with grief education and emotional support, free of charge for all families. Led by grief professionals and trained volunteers, Camp Erin provides a unique opportunity for youth to increase levels of hope, enhance self-esteem, and especially to learn that they are not alone.

  • Important Enrollment Details

  • Camper applications are processed on a first come first served basis, with priority given to new campers.*

    A family interview is required for all campers, and acceptance to camp will be communicated only after the family interview.

    *Campers that have previously attended any Camp Erin will automatically be placed on the waitlist. Please inform the staff if your child has experienced another significant death since attended. 

    For more information, please call/text (208) 791-719, or email campdirector@willow-center.org.

  • Parent /Guardian Information

  • Format: (000) 000-0000.
  • How did you hear about Camp Erin?*
  • What are your preferred methods of communication? (Check all that apply)*
  • Primary/ #1 Preferred Method:*
  • Format: (000) 000-0000.

  • Child Information

  • Camper Date of Birth*
     - -
  • Camper would prefer which cabin?*
  • Camper shirt size*

  • Bereavement History

    If your camper has lost more than one person, please separate names using a comma or “/” and keep the same order throughout this section.
  • Was the deceased a significant caregiver of the camper?*
  • Has your camper experience any other deaths? (e.g. pets, distant relative)*

  • Camper Behavior

  • Has the camper exhibited any of the following behaviors in the last TWO months? (select all that apply)*
  • Is the camper currently under the care of a counselor/mental health professional?*
  • Has your child had any recent or past interaction with law enforcement or the judicial system that may be helpful for us to know when supporting them at camp? (This information does not automatically prevent a child from attending camp. We may ask follow-up questions during the family interview.)*

  • Medical Information

    Please provide any medical information needed to help us safely care for your camper during camp, including medications, allergies, and emergency medical needs.
  • Does your camper take any medications they need to take regularly while at camp (prescription or over-the-counter)?*

  • Please list all your camper's current medications. We understand these might change before camp.

    ALL MEDICATIONS MUST BE IN ORIGINAL CONTAINERS WITH CAMPER'S NAME & PRESCRIPTION ON LABEL WHEN ARRIVING TO CAMP REGISTRATION. Over-the-counter medications must be in the original manufacturer packaging.

  • Does your camper have a medical action plan related to a severe allergy?
  • Does your camper use an EpiPen? If yes, please bring to camp.*

  • Demographics

    The following demographic questions are optional. Your responses will not affect your camper’s eligibility or acceptance into camp.
  • Race/Ethnicity (check all that apply)
  • Was the Deceased an active, reserve, or National Guard military member or military veteran?
  • Is the camper's parent/guardian an active, reserve, or National Guard military member or military veteran?

  • Emergency Contact Information

    Please select two other individuals as emergency contacts other than yourself.
  • Format: (000) 000-0000.
  • Optional Pickup*
  • Format: (000) 000-0000.
  • Optional Pickup

  • Acknowledgment:
    By selecting either option, I understand that:

    If it is necessary for my child to leave Camp Erin before the end of the program due to illness, injury, or behavioral issues, and I cannot be reached, Camp Erin may release my child to the emergency contact(s) listed above.

    Camp Erin may require photo identification from anyone picking up my child.

    I release Camp Erin, its staff, volunteers, and representatives from liability for releasing my child to the person(s) listed above.

    In the event of necessary health care or other emergency, Camp Erin may release my child to health care providers or other appropriate personnel.

     

    Optional Pickup Authorization:
    If I select “Yes” on Optional Pickup, this authorizes my emergency contact to pick up my child at the end of camp in my stead.

  • Final Acknowledgment & Consent

    By signing below, I acknowledge that I have read and understand this application and agree to the terms and conditions outlined within it. I certify that the information I have provided is true and complete to the best of my knowledge.

    I give permission for Willow Center to contact me by phone, text message, or email to complete scheduling for our family interview.

    I understand that additional forms and required documentation must be completed in addition to this application.

  • Date*
     - -
  • Should be Empty: