Caregiver Interest Form

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We're excited that your child is interested in attending Camp HOPE America-Arkansas! Please answer the questions below thoughtfully and honestly so that we can know a little bit more about your child. Due to limited space, please note that we are not able to guarantee attendance for any child.

We will soon schedule a Meet and Greet where we can learn more about your child and how they might benefit from participating in Camp HOPE America-Arkansas.

If you have any questions or concerns, please feel free to contact Adri or Alexis by email at amejia@wcfarkanasas.org or aboling@wcfarkansas.org . Thank you for your interest and understanding!

Email *

Your Name *

First and last name

Email that is best to reach you? *

Phone number *

What is your relationship to the child? *

What is the child's name and birthdate?

What grade will your child be entering in the fall?

Has your child attended overnight camp in the past? If yes, when?

Are you currently receiving services (therapy, job training, childcare, etc.)?

Yes

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Is your child currently receiving services (therapy, childcare, etc.)?

Yes

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Does your child have any behavioral issues that might interfere with a week at Camp HOPE America-Arkansas?

What do you think your child might gain from attending Camp HOPE America-Arkansas?

What does your child do when they are angry or experience conflict?

Has your child processed their trauma with a professional? If yes, please provide the name and phone number of their therapist/social worker?

What are some potential challenges that might arise if your child were to attend camp?

Is there anything else that would be helpful for us to know in advance?

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