Camp Charlie Registration Application

Thank you for your interest in your family attending Camp Charlie Colorado 2025.  We are excited about this year's camp and look forward to a meaningful camp experience.  Please read through this entire cover page for important information about camp and the application process.

- Please add charliesguys@gmail.com as a safe sender to your address book and be sure to check your junk/spam folder in case an email inadvertently goes there.  

- Camp Charlie Colorado 2025 will be held October 17 - 19 at Cal-Wood located near Jamestown, CO.

- The road to Cal-Wood will require a 4 wheel drive vehicle. Campers are responsible for getting their families to camp independently (we will not be providing transportation).

- Cal-Wood has a supply room with boots, gloves, jackets and other winter apparel if needed. Bedding will also be provided if you plan to travel and do not want to pack your own.

- We will be contacting you via phone, text and/or email to schedule an interview with you after we have received their application.  This gives us an opportunity to talk about camp, learn more about the death loss and determine whether camp is a good fit for your family at this time.  It will also give you an opportunity to ask any questions you and your family have.  We anticipate beginning to schedule those interviews later in the spring.  

-   The interviews typically takes 45 - 60 minutes. We appreciate your making time for the interview a priority as we are unable to accept a family to camp without having had the pre-camp interview.    

- Please be aware that after three attempts to contact you without a response, we will consider your family's application inactive.

- All adults will be background checked and filling out this form approves of each search. You will receive an invite through the CARE portal to submit your information for the background check. We have the right to refuse any family based on these findings. 

- Pending the outcome of the pre-camp interview and background check, campers will be accepted on a first come basis.  Once we reach capacity in a cabin group, additional new camper applicants will be wait listed on a first come basis.  

- Camp is FREE for all attending but in order to secure a spot, we will require a deposit via a sliding scale (collected upon acceptance into camp) that we will refund at the start of camp to ensure no last-minute cancellations. Cancellations prior to 30 days will be refunded in full. 

- If you have any questions in the interim, please reach out to us by email at charliesguys@gmail.com

Kjerstin Davies

President, Charlie's Guys

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Email *
2nd Adult Email address attending if applicable (parent/guardian or sibling)
Campers Info:
First and Last Name, Gender, Pronouns, Age as of October 1, 2025, Birthdate
Example: Kjerstin Davies, F, She, 41, Jan 5, 1984
 *
Camper's Race/Ethnicity 
We use this information to gather demographic statistics
 *
Does the camper applicant qualify for or receive free or reduced lunch at school? *
Primary Contact Person (Filling out Form) *
Phone Number *
Home Address *
How did you hear about Camp Charlie? *
Name of the person who passed away. *
Relationship to parents and children. *
Date of death *
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Age of deceased at the time of death *
Cause of death *
Was the death anticipated or sudden? *
Was the deceased receiving hospice services at the time of death? *
Verification/documentation of the loss. Example: Obituary (link or paper), or name and phone number of funeral home, or gofundme page, or any other proof *
What did the family call this person? *
Was the deceased a primary caregiver of the child? *
DESCRIBE THE RELATIONSHIP BETWEEN THE CHILD AND THE DECEASED AND THE ADULT AND THE DECEASED: (e.g. close, distant) *
WAS ANYONE PRESENT AT THE TIME OF DEATH? *
DID ANYONE SEE THE DECEASED AFTER DEATH? *
HOW DID EVERYONE REACT TO THE DEATH? *
DID THE FAMILY ATTEND THE FUNERAL / MEMORIAL SERVICE? *
IF YES, WHAT WERE THE FAMILY'S REACTIONS TO/COMMENTS ABOUT THE SERVICE? *
DO YOU AND YOUR FAMILY TALK ABOUT THE DECEASED? *
DID THE CHILD/FAMILY/PARENTS RECEIVE GRIEF COUNSELING OR OTHER COUNSELING BEFORE OR AFTER THE
DEATH? *
IF YES, SPECIFY THE SERVICES RECEIVED AND LENGTH OF SERVICE:
DESCRIBE HOW THE CHILD AND PARENTS INDICATES THEY ARE GRIEVING: *
PLEASE CHECK IF EITHER OF THESE STATEMENTS IS TRUE:
IF EITHER BOX IS CHECKED, PLEASE EXPLAIN:
HAS THE FAMILY/CHILD EXPERIENCED ANY OTHER DEATHS, RECENT LOSSES OR CHANGES? IF YES, PLEASE EXPLAIN *
HAVE ANY OF THE CAMPERS EXHIBITED ANY OF THE FOLLOWING BEHAVIORS SINCE THE DEATH OCCURRED?
(check all that apply) *
Required
PLEASE PROVIDE MORE INFORMATION ABOUT THE BEHAVIORS CHECKED ABOVE INCLUDING WHAT
HELPS THE PERSON WHEN THEY EXPERIENCE ANY OF THE ABOVE *
HAS ANYONE'S BEHAVIOR, INCLUDING THINGS THEY HAVE SAID OR DONE, CONCERNED YOU SINCE
THE DEATH? *
If yes, please explain
HAVE YOU NOTICED A CHANGE IN THE CAMPER'S FRIENDSHIPS OR PEER RELATIONSHIPS? IF YES, EXPLAIN *
ARE THERE THINGS THAT CAUSE YOUR CAMPER TO BECOME UPSET OR FRIGHTENED, OVERWHELMED
OR DISTRESSED? IF YES, EXPLAIN(e.g. noises, smells, words, etc.) *
IF YES, PLEASE EXPLAIN INCLUDING WHAT HELPS THE PERSON WHEN SUCH AN EXPERIENCE HAPPENS:
HAS THE CAMPER EVER BEEN INVOLVED IN THE JUVENILE JUSTICE OR JUSTICE SYSTEM? *
IF YES, CHECK ALL THAT APPLY:
PLEASE PROVIDE MORE INFORMATION ABOUT THE ITEMS CHECKED ABOVE:
HAS THE CHILD/PARENT EVER EXPERIENCED ABUSE OF ANY KIND? *
If yes, please explain
DESCRIBE ANY OTHER CHANGES/STRESSES IN THE FAMILY'S LIFE: (e.g. divorce, illness, moving) *
HAVE YOU AND THE CHILD TALKED ABOUT THEIR PARTICIPATION AT CAMP CHARLIE? *
WHAT, IF ANY, CONCERNS DO YOU HAVE ABOUT THE CHILD/FAMILY COMING TO CAMP? *
Describe each child's experience with sleeping away from home and camp. If they have attended day camp, sleep away camp, etc. and how they did. *
LIST ANY SPECIAL INTERESTS OR HOBBIES THE CHILD/PARENT HAS: *
IS THERE ANYTHING WE SHOULD KNOW ABOUT THE FAMILY'S RELIGIOUS BELIEFS OR FAITH PRACTICES? *
WHAT WOULD YOU HOPE THE CHILD WOULD GAIN FROM ATTENDING CAMP CHARLIE? *
Emergency Contact Information of Person not attending Camp
Example: Kjerstin Davies, Sister/Aunt/720-949-3388
 *
Physician's Name, Practice, Location, Phone Number *
Preferred Hospital *
IS THE CAMPER CURRENTLY UNDER THE CARE OF A COUNSELOR/MENTAL HEALTH PROFESSIONAL? *
If Yes, provide name and phone number of professional
DOES THE CAMPER HAVE ANY OF THE FOLLOWING MEDICAL CONCERNS (check all that apply): *
Required
PLEASE PROVIDE MORE INFORMATION ABOUT THE MEDICAL CONCERNS LISTED ABOVE:
IS THE CAMPER ALLERGIC TO ANYTHING? 
(Please specify below with severity and reaction)
 *
MEDICAL ALLERGIES:
FOOD ALLERGIES:
PLANT ALLERGIES:
ANIMAL / INSECT ALLERGIES:
OTHER ALLERGIES:
DOES YOUR CAMPER USE AN EPIPEN? 
(If yes, please bring to camp)
 *
DATE OF CAMPER'S LAST TETANUS SHOT 
(DTAP or TDAP):
Tetanus boosters are recommended every 10 years. If not up to date, it is required to get a Tetanus booster prior to camp
 *
ANY DIETARY RESTRICTIONS 
(vegetarian, gluten free, etc.):
 *
Has any camper had any operations? If yes, please explain. *
HAS THE CAMPER HAD ANY SERIOUS OR CHRONIC ILLNESSES? If yes, explain. *
DOES THE CAMPER HAVE ANY KNOWN PHYSICAL, MENTAL, OR SOCIAL DIFFICULTIES THAT MAY AFFECT PARTICIPATION AND/OR FOR WHICH CONSIDERATION SHOULD BE GIVEN? *
IF YES, PLEASE SPECIFY INCLUDING WHAT HELPS THE CHILD WHEN THE CHILD EXPERIENCES ONE OF THESE DIFFICULTIES
If actives need to be restricted in any way, please explain.
If anyone is currently taking any long-term medications, please explain.
If "Yes", please list all of the current long-term medications. We understand that these might change
before camp.ALL MEDICATIONS MUST BE IN THE ORIGINAL CONTAINER WITH PRESCRIPTION.
By signing below, I am certifying that all information in this application to be true, complete, and correct to the best of my knowledge and belief. I am also certifying that I am the legal parent/guardian of the above named child, known in this form as "camper" or "child".
I am authorizing Camp Charlie/Charlie's Guys to contact me by phone, text, and/or email regarding my child and with information about Camp Charlie and Charlie's Guys. I understand that there may be additional forms to fill out and that there will be a family interview prior to my family's acceptance into Camp Charlie.
Name of parent or legal guardian *
State you live *
City you live *
Relationship in family *
Date *
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Email *
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