Joshua's Camp Application

If you are interested in applying for Joshua's Camp, you may either fill out the online form below.

To provide the best possible experience at Joshua's Camp, your application must be completed in full and returned to Joshua's Camp Administration. Please try to combine all required Forms and Applications (Medical Clearance and Professional Referral) together to help us with processing.

Application Instructions:

The application process to attend Joshua’s Camp requires submission and approval of three forms:

A Family Application, to be completed by the parent or parents,
A Medical Assessment and Clearance Form, to be completed by the cancer child’s Oncologist, Hematologist or Pediatrician and
A Joshua’s Camp Referral Source, to be completed by the Child’s Oncology Facility or a Recognized Oncology Agency. Joshua’s Camp accepts families (immediate members) that have a child 0-17 years of age that is being treated for cancer or has been out of treatment for three years or less. Qualifying applications are accepted on a first come basis or based on special circumstances. Direct calls to Cathy Finney, Camp Director at 715-514-1485 or Wendy Carey, Assistant Camp Director at 715-271-9807. The Family Application must be completed online. After the Family Application is reviewed, an acknowledgment and the other required forms will be sent to the family with directions how to proceed.

Person Completing Application

Name *

Date *

Referral Name

Treatment Child

Name *

Date of Birth *

Sex * Male Female

Age *

Parent/s or Legal Guardian/s

Mother's Name

Father's Name

Home Address

City / State / Zip *

Phone Numbers

Email Address

Other Children

Please list the names and ages of all other children who will be staying with you at Camp.

Child #1

Add Child

Medical Concerns

Do any of these children have a medical or other concern or condition? If YES, please explain:

Emergency Contact Information

Contact #1

Name

Address

City / State / Zip *

Phone Numbers

Contact #2

Name

Address

City / State / Zip *

Phone Numbers

Medical Facility

Please indicate the medical facility where your child is currently being treated:

Name

Address

City / State / Zip *

Phone Number

Best Contact Person

Name

Phone Number

Child's Attending Physician/s

Please indicate the best contact information for your child's current physicians.

Physician #1

Physician's Name

Specialty

Contact Information

Physician #2

Physician's Name

Specialty

Contact Information

Diagnosis & Treatment

Child's Diagnosis

Current Treatment

Is your child currently in treatment? Please explain:

Last Treatment Date

Special Needs

Note: Metropolis Resort is handicap-accessible.

Child's Condition

Please describe your child's overall condition and any special needs or considerations (food allergies, wheelchair, oxygen use, one-to-one attention, etc.):

Family Medical Conditions

Does anyone else in your family have a medical condition we should be aware of? (food allergies)

Miscellaneous

Special Interests

Does anyone in your family have any special interests, talents, or hobbies?

Expectations

What are your expectations and/or hopes for your visit to Joshua's Camp?

Your Story

Please tell us your child's story. You may give as much detail as you wish.

Other Comments

Is there anything else that you would like to share that would enable us to better serve you during your stay?

Photo (Optional)

If you wish, you may upload a photo of your family (for best results, please make sure the image is a JPEG under about 4MB).

By checking this box, I attest that all of the above information is true and complete to the best of my knowledge.

Joshua's Camp Application

Application Instructions:

Person Completing Application

Treatment Child

Parent/s or Legal Guardian/s

Other Children

Emergency Contact Information

Contact #1

Contact #2

Medical Facility

Best Contact Person

Child's Attending Physician/s

Physician #1

Physician #2

Diagnosis & Treatment

Special Needs

Miscellaneous

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