Refer a Camper to Camp Casey!
Camp Casey is a 501(c)(3) organization that provides cost-free horseback riding programs for children with cancer and rare blood disorders in Michigan. By referring a family to Camp Casey, you can help us continue to deliver happiness on horseback to a child with cancer or a rare blood disorder in your community.

To qualify for Camp Casey's programs, a child must: Be seventeen years old or younger AND have been diagnosed with or treated for a life-threatening (progressive, degenerative, or malignant) illness within the past two (2) years.

*Please note that this is not a form of solicitation. All referrals to Camp Casey will be contacted with the purpose of serving the family with Camp Casey's cost-free horseback riding programs.
Sign in to Google to save your progress. Learn more
Your Name *
Your Email Address *
Parents' First and Last Name(s) *
Child's First Name *
Diagnosis (if known)
Parents' Phone Number *
Parents' Email Address *
Where is the family located? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Camp Casey. Report Abuse
Google Forms