Camp HOPE Camper Nomination Form 2018
We’re excited that you’ve chosen to nominate a child to attend Family Support Center’s Camp HOPE 2018! Camp HOPE America- Washington is first camping and mentoring initiative in the state to focus on children exposed to domestic violence. Please answer the questions below so that we can know about a bit more about the child you are nominating. Due to limited space, please note that we are not able to guarantee attendance for any child. Campers should be ages 7-17. We will be conducting screening interviews in February through May with children and their parent/guardian before officially offering spots for camp. Thank you for your understanding!
Email address *
Your contact information
Name:
Your answer
What is your phone number?
Your answer
What is your email address?
Your answer
What organization do you work for?
How did you hear about Camp HOPE?
Your answer
Information about the child you are nominating
Child's name
Your answer
Age (We accept campers ages 7-17)
Your answer
What are the names of parent/guardians of this child?
Your answer
Please provide a phone and email address for the parent/guardian that the child resides with. We ask that the parent/guardian be notified by you prior to submitting this application, to ensure their interest in Camp HOPE.
Your answer
Has this child been impacted by domestic violence?
If yes, has physical/ emotional safety been an issue for this child?
Is this child currently in a stable home environment?
Has this child had the opportunity to process their story with a mental health professional?
Does the child have any known aggressive behaviors towards other children?
Do you know of any special accommodations this camper may need if attending camp?
Your answer
Is there anything that would be helpful for us to know in advance?
Your answer
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