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    Please complete the form below to attend.

    1. How many people in your party attending?

    2. If this campaign is a physical event, the organization may need to contact you. Please provide your info below.

    Additional Info.

    Please review the information and complete this form.

    1. Thank you for your interest in KiDS NEED MoRE Camp Adventure! 

      Please fill out this Pre Camp Application and a representative will contact you shortly with MoRE information on how to apply for Camp Adventure 2017. 

      KiDS NEED MoRE Camp Adventure is open to children & teens ages 6-18 who are coping with cancer. This includes cancer patients, survivors, siblings of patients & survivors, & bereaved siblings. Camp Adventure is FREE of charge to all families.

      Camp Adventure 2017 will run August 12th - August 18th. We are located at the Quinipet Camp & Retreat Center on Shelter Island. Buses are provided from Long Island & Brooklyn. For families who live more than a 2 hour drive from the campsite, free air transportation is available through Patient Airlift Services. 

      For MoRE information about Camp Adventure visit http://kidsneedmore.org/campadventure/ or contact info@kidsneedmore.org

      **PLEASE NOTE: This form is NOT a complete Camp Adventure application, more information as well as health forms will be required for your children to attend Camp Adventure**
      1. Name of Parent/Guardian *
      2. Phone Number *
      3. Email Address *
      4. Name of Child 1 *
      5. Age of Child 1 *
      6. Child 1's Current Grade in School *
      7. Does Child 1 have any physical limitations, behavioral diagnosis or issues, and/or cognitive impairments we should know about? (This question is for safety only, we strive to accommodate every child at camp) *
      8. Which of the following best describes child 1? *
      9. Name of Child 2
      10. Age of Child 2
      11. Child 2's Current Grade in School
      12. Does Child 2 have any physical limitations, behavioral diagnosis or issues, and/or cognitive impairments we should know about?
      13. Which of the following best describes child 2?
      14. Name of Child 3
      15. Age of Child 3
      16. Child 3's Current Grade in School
      17. Does Child 3 have any physical limitations, behavioral diagnosis or issues, and/or cognitive impairments we should know about?
      18. Which of the following best describes child 3?
      19. Names, ages, and any additional information for other children interested in Camp Adventure?
      20. Diagnosis & Date of Diagnosis of the Patient *
      21. Is the patient currently on active treatment? *
      22. Is the patient interested/able to attend Camp Adventure 2017?
      23. How did you learn about KiDS NEED MoRE Camp Adventure?
      24. Is your family interested in using Patient Airlift Services to get to camp (must live more than a 2 hour drive from the camp site to qualify)?
      25. Is your family interested in our MoRE Hope for Johnathon Program including toy & gift basket deliveries, friendly visits at the home or hospital, and MoRE available to current & former patients and siblings?

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