Our goal is to provide healing and a fun atmosphere in the outdoors to a child and
surrving spouse. Candidates must be under the age of 18 and have lost a parent
to be eligable.
Your name:
Relation to Child:
Mailing Address:
Your email address:
Your phone number:
Age of Child:
Child Name:
Tell Us about yourself
and your loss:
The surrviving parent or guardian should complete this form.