Kansas Trailblazers Weekend: April 17th-19th, 2026
Welcome to Kansas Trailblazers Weekend at Camp Wood! KSSB is once again excited to partner with Envision, Inc., Camp Wood YMCA, and the Foreseeable Future Foundation to provide this fun-filled weekend! 

Learning Intentions:

1. I am learning to meet and interact with new people.

2. I am learning Recreation and Leisure skills of horseback riding, climbing, boating and archery.

3. I am learning to implement the 5 Step Process of Self-Advocacy.

This event promotes an increase in all areas of the Expanded Core Skill with specific emphasis on Social Skills, Recreation and Leisure and Self-Determination.

PLEASE READ the requirements to attend before registering your student/young adult.  

Registration is limited - Register Early!!!  DEADLINE TO APPLY is March 6th, 2026.
 
Participants must be:
     - age 12 to 18 years (5th -12th grade). No older than 18 years.
     - independent in all self-care including toileting and showering.
     - independent in managing clothing and personal items.
     - independent (age appropriate) in travel/cane skills (Does not need 1:1 to travel).
     - able to locate stairs/drop-offs/obstacles in variety of environments. 
     - able to independently get in and out of a vehicle.
     - have a signed waiver and media release. 
     - registered to attend via this Google Form.

Priority is given to students who DO NOT attend KSSB full time.  KSSB reserves the right to deny acceptance into any Trailblazers weekend programs.  

Spots for current KSSB students will be put on a waitlist by order of application, and contacted once registration closes on March 6th, 2026.

A parent letter with more information will be sent to each applicant upon acceptance. 
Transportation may be provided from KSSB or from Envision (Wichita).  More information to come.

For additional information or questions, please contact: 
Anna Cyr, acyr@kansasblind.gov, or Courtney Wages,  Courtney.Wages@envisionus.com
 
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Student Information
Participant Date of Birth *
MM
/
DD
/
YYYY
Participant Name *
Participant Current Grade *
Required
Participant District and USD # *
Participant TSVI *
Participant Eye Condition *
Participant Vision  *
Participant E-mail (put NONE if no email) *
Participant Cell Phone # (put NONE if no phone).  *
Parent / Guardian Name *
Street Address *
City *
State *
Zip Code *
Transportation TO Camp Wood on Friday, April 17. *
Required
Transportation FROM Camp Wood on Sunday, April 19. *
Required
Parent / Guardian email  *
Parent / Guardian Cell # *
Emergency Contact 1 Name *
Emergency Contact 1 Phone # *
Emergency Contact 2 Name *
Emergency Contact 2 Phone # *
Participant Allergies to FOOD *
Participant Allergies to ENVIRONMENT *
Participant Allergies to MEDICINE *
Participant Medications during weekend *
Health Insurance Company *
Insurance Holder Name *
Policy Group Number. *
Kan Care Card # (If Applicable)  *
I hereby release Envision and all Heather's Camp staff/volunteers from any and all claims and liability arising from any injury, illness, damages or loss or destruction of personal property, which may occur as a result of my or my child's participation in or traveling to or from the program activities.
Please type your full name below.
 *
Consent to use name and likeness

I grant permission to Envision, to use my or my child's image, voice recording or likeness on its website or in other official publications without further consideration, and I acknowledge Envision's right to crop or treat this media at its discretion. I also acknowledge that Envision may choose not to use this media immediately, but may do so at its own discretion at a later date. I also understand that once this media is posted on Envision's website or in other official publications, it can be downloaded or shared. Therefore, I agree to indemnify and hold harmless from any claims the following: Envision, Inc. and all Heather's Camp staff or volunteers.

Please type your full name below.
 *
I consent for me or my child to be transported during the program by authorized staff or contracted entities to and from activities associated with the program, ex. Envision vehicles.
 *
Please type your full name below acknowledging you have reviewed the above information regarding the Kansas Trailblazers Weekend including: Abilities of participant and waitlist protocol for applicants.   *
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