SunriseVX Registration Form

Hi there! By completing this form, you’re signing up for this SunriseVX event or program. Plus, you’ll be able to optionally join any of our other virtual events throughout the year—including monthly events and our summer camp—all free of charge!

Notice: Required fields have a dotted underline.
Notice: Required fields are marked with a red asterisk at the end.
Mailing Address
Country
Address
City
State
Zip
About You (Parent/Guardian)
First Name
Last Name
Relationship
Email
Phone
Ex: 303-555-5555
 

How would you prefer to be contacted?

( Best time to call   )
How did you hear about us?
Add another parent/guardian from your household.

Add another parent/guardian from your household.

About Your Child
First Name
Middle Name
Last Name
Preferred Name
Email
Gender
Date of Birth
School
Grade
2024-2025 School Year
Season Of Interest  
Describe Your Child
Your Child's Interests
Previous Experience at Camp

Hospital Affiliation 

Hospital Affiliation (other) 

Is this child a child with cancer or a sibling? 

If the child with cancer is not attending, please list their name 

Initial Diagnosis 

Diagnosis Date 

Is your child currently on active treatment?  

(If no) Date of Last Treatment  

By signing below, I acknowledge that I have reviewed and agree to the terms and conditions listed for participation in SunriseVX's virtual programs.

ELIGIBILITY REQUIREMENTS:
– Any child aged 3 to 16 who is within the first five years of cancer diagnosis or treatment.
– Any sibling of a child who meets the above criteria.

PERMISSIONS:
– I acknowledge and accept that my child(ren)/family may be participating in video activities and webinars that may include them being seen and heard on a webcam over the internet.
– I acknowledge and accept that SunriseVX/Sunrise Association will be using a third-party platform like Zoom to facilitate video sessions and I agree that Sunrise VX/Sunrise Association assumes no liability for any performance issues with Zoom or any other third-party software.
– I will encourage my child(ren) to follow appropriate online conduct as explained to them and written in the parent manual or risk losing privileges to participate.
– I acknowledge and accept that others may see our home environment during live sessions.
– By allowing your child to participate in our virtual programs, you are granting Sunrise Association Camps the right to use such images and/or recordings. I acknowledge and accept that virtual camp program sessions may be recorded from time to time, and that all or portions of such recordings/images may be used for purposes including but not limited to sharing with children and families, staff and/or potential staff, teaching and training, and/or marketing/fundraising. 

Additional comments 

I agree to the Privacy Policy and Terms of Use
Children's privacy is of primary concern to us, and our Policy and practices reflect applicable laws and regulations on children's privacy. We do not knowingly collect personal information from children under 18 years of age. Any communication we get that is identified as being from a child under 18 will be immediately removed from our database. All information gathered from our camp families is used exclusively for camp, and no third-party vendors. We urge parents to regularly monitor and supervise their children's on-line activities.