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The Painted Turtle Camp Application Scleroderma Kids Alliance 

APPLICATIONS ARE DUE BY JUNE 1st, 2026


💙 Welcome to Scleroderma Kids Alliance Family Camp! 💙 

Haga clic aquí para la versión en español de la aplicación

We are so excited to invite your family to a one-of-a-kind experience created just for children living with scleroderma and the people who love them. Our goal is to create a space where kids feel understood, families feel supported, and no one feels alone.

Camp Details:
📅 July 5–9
📍 The Painted Turtle in Lake Hughes, California
👨‍👩‍👧‍👦 Family Camp – children with scleroderma and their families are welcome

This application helps us get to know your family so we can create a safe, supportive, and meaningful experience for everyone. Information you provide will also help us plan for medical needs, accommodations, and travel support if needed.

Please note: We know forms can feel overwhelming—answer what you can, and don’t hesitate to reach out if you need help. We’re here for you every step of the way.

We can’t wait to get to know your family and welcome you to the SKA community 💛

***Important Instructions *** 

There are 3 parts to the application

Step 1- Please fill out this release form from The Painted Turtle (click "this release form")

Step 2- Fill out this Google Form application

Step 3- Print out  Physician's medical release form  and have it filled out by your child's treating physician. 

Email *
What is the name, pronoun, and date of birth of your camper diagnosed with scleroderma attending camp?  *
What is the name, pronoun, and date of birth of any siblings who will attend camp?  *
Name of caregivers attending camp. What is your relationship to the camper with scleroderma? *
Caregiver #1 email address and phone number *
Caregiver #2 email address and phone number
Please list an emergency contact and phone number
 (not attending camp)
 *
Family's mailing address 
What type of scleroderma does your child have? *
What year was your child diagnosed with Scleroderma?
Who is the treating physician for your child with scleroderma. Please include their office phone number.  *
Does anyone in your family have any dietary restrictions/food allergies? Please include who the restriction/allergy corresponds to *
Does anyone in your family have any environmental allergies? Please include who the allergies correspond to. *
What is the primary language spoken at home? *
Does anyone attending camp have mobility restrictions? If yes, please explain. (Wheelchair, Fatigue, limited mobility,  etc) *
Any recent hospitalizations/complications or concerns? *
What are your child’s biggest challenges right now? *
What do you hope your CHILD gains from camp? *
What do YOU (parent) hope to gain from camp? *

Will your family need financial assistance for travel? If so please include departure city and number of travelers. 

Have you or your child ever attended a camp?
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Has your child met another child with scleroderma before? *
Is this your first time attending a scleroderma-related event? *
If yes, what was the scleroderm-related event you attended?
Is there anything else you’d like us to know about your child or family?
How did you hear about the Scleroderma Kids Alliance Camp? *
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