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Virtual Camp Dates: Coming Soon!

We are thrilled to welcome you and your child(ren) to SunriseVX 2024, our Virtual Camp eXperience – free of charge – for child(ren) with cancer, ages 3 1/2 -16 and their siblings.  

Please note - if you intend to register for in-person camp for Summer 2024, click here. The application below is intended for families choosing to enroll their child(ren) in our virtual camp experience.

For any questions regarding SunriseVX, please contact Athena Levesque at sunrisevx@sunriseassociation.org.

Basic Info

How did you hear of SunriseVX? *

Camper Info

Once enrolled, all campers are welcome to attend all VX programs throughout the year.
Child with cancer/Camper #1 *
 First NameLast NameGenderDate of Birth2023-24 School GradeSchoolNew or Returning CamperLanguage (if other than English)
Camper #1
Are you registering more than one camper? *

Siblings
 First NameLast NameGenderPronouns (Optional)Date of Birth2023-24 School GradeSchoolNew or Returning Camper
Camper #2
Camper #3
Camper #4
Camper #5
Preferred Language *




Medical Info

On Active Treatment? *
Social Worker/Hospital Contact Info
Referring Oncologist Contact Info
Primary Care Physician Contact Info

Parent/Guardian Info

Parent/Guardian #1 Contact Information *
 First NameLast NameRelationshipGender
Parent/Guardian #1
Preferred Language? *
Parent/Guardian #2 Contact Information
 First NameLast NameRelationshipGender
Parent/Guardian #2
Preferred Language?

Family Demographic Information

The following is for use by the Sunrise Association when applying for funds from various sources and will not affect your ability to attend camp for free, regardless of your income.

Information that we provide to third parties will never identify you nor your family members but will rather be grouped together with other families’ as part of overall statistics.

Virtual Camp Info

I hereby give permission for my child(ren) to be contacted directly, either by text message and/or email, for virtual camp program reminders: *
Camper Contact Info
Camper Contact Info *
 Camper NameCell Phone
Camper #1
Camper Contact Info *
 Camper NameCamper Cell Phone
Camper #2
Camper #3
Camper #4
Camper #5

Permissions

I acknowledge and accept that my child(ren)/family may be participating in video activities and webinars that may include them being seen and heard on a webcam over the internet. *
I acknowledge and accept that Sunrise VX/Sunrise Association will be using a third-party platform like Zoom to facilitate video sessions and I agree that Sunrise VX/Sunrise Association assumes no liability for any performance issues with Zoom or any other third-party software. *
I will encourage my child(ren) to follow appropriate online conduct as explained to them and written in the parent manual or risk losing privileges to participate *
I acknowledge and accept that others may see our home environment during live sessions. *
By allowing your child to participate in our virtual program, you are granting Sunrise Association Camps the right to use such images and/or recordings.I acknowledge and accept that virtual camp program sessions may be recorded from time to time, and that all or portions of such recordings/images may be used for purposes including but not limited to sharing with children and families, staff and/or potential staff, teaching and training, and/or marketing/fundraising. *
These authorizations are limited to the date signed below through July 1st of the following year. By signing below, I agree to signing this release and the items as initialed above *
clear
I hereby give permission for my child(ren)’s name(s), family address, phone number and email to be listed in the camp directory and distributed to camper families in the Sunrise Association Camps community. *
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