2024 Summer Day Camp Counselor

August 5th-8th, 2024

*Half Day virtual training & background check required!

* First & Last Name
0/50
* Home Address, City, State, Zip
0/250
* Phone Number (Please provide the best number to reach you)
0/50
* Email Address (Please provide the best email address to communicate with you)
0/50
* Gender
* Date of Birth (Month/Day/Year)
0/50
* What type of Sickle Cell Disease do you have?
0/250
* Camp T-Shirt Size
* Food Allergies? Y/N? If yes please list the allergy or allergies below, If no please state No in the box below! This will assist us in planning for lunches and snacks during camp.
0/250
* Are you related to a sickle cell day camp participant?
* Did you participate as a camp counselor last year 2023?
* Please type in below the name of where you currently go for your Sickle Cell Care?
0/250
* Emergency Contact Person (List Name, relationship to you & telephone number)
0/250