Dream Day Holiday Weekend 2021
REGISTRATION IS CLOSED. Deadline was 10/31/2021.

We are excited to be able to offer our 2021 Holiday Weekend on December 3-5, 2021 at the Doubletree Hilton Hyannis, MA. Applications will be accepted on a first come first served basis with preference given to first-time attendees.  

Please note that Dream Day serves immediate family members only (PCA/aide acceptable if REQUIRED.) The deadline for application is OCTOBER 31, 2021. Families will be notified beginning November 2, 2021. Please visit www.dreamdayoncapecod.org for more information or email ed@dreamdayoncapecod.org.

Evolving Covid protocols will be shared with accepted parties. You will be required to sign a Covid protocol agreement as well as a waiver before participation.

ELIGIBILITY: Families cannot have attended the Holiday Weekend more than once before. Primary applicant child with a diagnosis must be under 18 years of age.
Sign in to Google to save your progress. Learn more
Email *
Parent(s) or Guardian LAST Name *
Parent(s) or Guardian FIRST Names *
House Number and Street Name (only) *
City *
State *
Zip Code *
Email Contact *
Best Phone Contact Number
Child's Last Name *
Child's First Name *
Main Diagnosis *
Year and Age of Diagnosis *
Child's Primary Language *
Child's Age *
Can He/She Speak English? *
Would your family need a wheelchair accessible room? *
Will attendance by your PCA or other aide be required? *
Please list all siblings (under 18) who will be attending. Include Full Name, Age, and Gender *
How many family members IN TOTAL will be attending (please include a PCA/aide if attendance is required.) *
Please tell us any information we should know about any family members including ANY allergies or medical needs the staff should know.  
Have you ever attended the Holiday Weekend before?   *
If you answered yes above, please provide year(s) of attendance.
How did you hear about Dream Day? *
From above, if you checked healthcare provider, hospital or social service agency, please list including name of contact (so that Dream Day may provide them with additional information to help other families.) Thank you!
Have you attended our summer camp? *
If you answered yes above, please provide year(s) of attendance at summer camp.
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dream Day on Cape Cod. Report Abuse
Google Forms