You may sign up one child per form. Once you click submit, you will be given an option to register another child. Thank you for your interest in Kathy's Camp!

Child's full name:

Child's birth date (mo/day/year):

Parent/Caregiver's full name:

Parent/Caregiver's email:

Parent/Caregiver's phone:

Family member diagnosed with cancer (mother, father, primary caregiver):

Type of cancer:

Treatment status:
Select one Newly diagnosed In treatment Metastatic disease Remission Other

Treatment facility (where you are getting or have received treatment):

Message or questions: (optional)

 

Participate

• Introduction
• Calendar of Events
• Sign Up to Participate
• Sign Up to Volunteer