2024 Hope With Heart Camper Intention
Whether you are new or a returning family, we can't wait to welcome your camper to Hope With Heart 2024! Please fill out the information below and then proceed with downloading our Camper Application from our website www.HopeWithHeart.org. Applications are due by April 30, 2024. If you have questions, please email Alissa Gretina, Camp Director, at HopeWithHeartApp@gmail.com. For medical questions, please call Dr. George Kipel, our Camp Pediatric Cardiologist, at (201) 741-0683.
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We are a "first-time" Hope With Heart family *
Camper's First Name *
Camper's Last Name *
Camper's Preferred First Name *
Camper's Gender Identity *
Camper's Birthdate *
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DD
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Camper's Age on August 4, 2024 *
Briefly describe your camper's CHD *
Camper's T-shirt Size *
Parent(s) / Guardian(s) First and Last Name(s) *
Mailing Address (Street, City, State, Zip Code) *
Parent / Guardian Preferred Cell Phone Number *
Parent / Guardian Preferred Email Address *
How did you learn about Hope With Heart? *
P.S. Our field trip to the Water Park is an all-time camper favorite! While Dr. Kipel chooses which rides are off limits, there remains an abundance of opportunity for safe fun! In order to create a positive experience for everyone, please check the activity/intensity level below that would most resonate with your camper. *
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