Camp Bluebird – Registration

Camp Bluebird Application 2024

Camp Bluebird is a family camp for children ages 6-18 and their parents or legal guardians who have experienced loss due to the death of a loved one. Our mission is to provide the necessary support and tools to manage and set grief free.

Child's First Name*

Child's Last Name*

Child's Address*

What was the last grade your child completed*

Child's Date of Birth*

Please select your Child's gender*
MaleFemale

Child's T-Shirt Size

Does your Child have any allergies?*
YesNo

If your Child has any allergies, please elaborate:

+ Second Child (optional)

Child's First Name

Child's Last Name

Child's Address

What was the last grade your child completed

Child's Date of Birth

Please select your Child's gender
MaleFemale

Child's T-Shirt Size

Does your Child have any allergies?
YesNo

If your Child has any allergies, please elaborate:

+ Third Child (optional)

Child's First Name

Child's Last Name

Child's Address

What was the last grade your child completed

Child's Date of Birth

Please select your Child's gender
MaleFemale

Child's T-Shirt Size

Does your Child have any allergies?
YesNo

If your Child has any allergies, please elaborate:

Parent/Legal Guardian's First Name*

Parent/Legal Guardian's Last Name*

Parent/Legal Guardian's Email*

Parent/Legal Guardian's Phone Number*

Will this Parent/Legal Guardian be attending?
YesNo

If Yes, what is the Parent/Legal guardian's T-Shirt Size

Second Emergency Contact's First Name

Second Emergency Contact's Last Name

Second Emergency Contact's Phone Number

Will this Contact be attending?
YesNo

If Yes, what is the Contact's T-Shirt Size

Please share with us the reason your Child is attending Camp Bluebird! Please be thorough as this helps us prepare activities for the camp.*

Contact Us
We Honor Veterans
Wellness Call Center
Hospice Bridge Program

Contact Us
We Honor Veterans
Wellness Call Center
Hospice Bridge Program

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