2020 Camper Registration - Camp DOVE
Who? Rising 3rd through 8th graders (Deaf and CODAs have priority)
When? June 28-July 4, 2020
Where? Camp DOVE will be held near Nashville, TN at the YMCA Camp Widjiwagan located at 3088 Smith
Springs Rd. Antioch, TN 37013.
Camper Cost: $550 (includes $25 non-refundable deposit which is REQUIRED at time of application.) Financial assistance is available; payment plans can be arranged.

Registration Deadline: April 1, 2020. Campers will be accepted after 4-1-20 until space is no longer available with Deaf receiving priority.
• ALL components of the application must be filled-out
• $25 per camper non-refundable deposit MUST be submitted with the registration form in order for the
application to be processed and your child to have a space held.
• A financial aid application will be on the Camp DOVE website by Jan. 15, 2020. Email Tammy Bowman with questions regarding financial aid at veathens@gmail.com.
Mailing address:
Visual Effects P.O. Box 80491 Athens, GA 30608
Make checks or money orders payable to Visual Effects/Camp DOVE.
Camper's first name *
Your answer
Camper's last name *
Your answer
Preferred name for name tag
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age at camp
Your answer
Grade (2020-21 school year) *
Your answer
Gender *
Your answer
Hearing Status *
Required
Communication Mode(s) *
Required
Child of Deaf Adult (CODA)? *
Required
Child has a sibling who is Deaf? *
Required
Camper Assisted Listening Devices *
Required
Race/Ethnicity *
Required
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
County (NOT country) *
Your answer
T-shirt Size *
Parent/Guardian #1 - First and Last Name *
Your answer
Parent/Guardian #1 - relationship to camper *
Your answer
Parent/Guardian #1 - Email *
Your answer
Parent/Guardian #1 - Best phone number to be reached *
Your answer
At this phone number #1, can someone be reached by voice only, text only, or both? *
Required
Parent/Guardian #2 - First and Last Name
Your answer
Parent/Guardian #2 - relationship to camper
Your answer
Parent/Guardian #2 - Email
Your answer
Parent/Guardian #2 - Best phone number to be reached
Your answer
At this phone number #2, can someone be reached by voice only, text only, or both?
Emergency Contact #1 - Full Name *
Your answer
Emergency Contact #1 - Relationship to camper *
Your answer
Emergency Contact #1 - Best number to reach them *
Your answer
Emergency Contact #2 - Full Name
Your answer
Emergency Contact #2 - Relationship to camper
Your answer
Emergency Contact #2 - Best number to reach them
Your answer
How did you hear about Camp DOVE? *
Your answer
Is your child a returning camper? *
If yes, write the year(s) he/she has attended camp. If no, write N/A.
Your answer
Is your child attending camp with a sibling? *
(If yes, write the name of the sibling(s). If no, write N/A.)
Your answer
List any camp activities in which, medically, your camper SHOULD NOT participate. *
Your answer
Does your camper have any food allergies? If so, list them. *
Your answer
Does your camper have any allergies to medications? If so, list them. *
Your answer
Medical Problems *
(check all that apply that have been diagnosed by a physician)
Required
Other information you would like us to know about your child:
Your answer
How would you like to receive the Parent Packet? *
(information about camp and required forms - due the first day of camp)
Required
Is your child up to date on his/her immunizations? (If no, please explain.) *
Your answer
PAYMENT (nonrefundable $25 deposit due at time of application to hold your child's place at camp) *
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