The day camp is for children ages 5-12 by the first day of camp, who live in or near the Santa Clarita Valley and live with a health challenge.

This form must be completed in its entirety by the legal parent or guardian of the camper(s). This form has NINE sections and will take approximately 45-60 minutes to complete. You cannot return to this form later, so you must complete it all now.

If you have more than one child attending camp, please fill out a new form for EACH child.

Email or call Eva Payne with any questions.

Email: glorimar@projectkindle.org
Phone: 626.736.8294

Thanks!