Camp Willow CreekJune 22-25, 2017

Complete and return by May 17 to: Camp CoordinatorTennova Hospice 311 Landrum Place, Suite A500 Clarksville, TN 37043931-552-9551 • 931-647-8111 (fax)CampWillowCreek.org

Child’s Name: _____________________________________

Street Address: ____________________________________

City/State/Zip: ____________________________________

Home Phone: _____________________________________

Birthdate: _____________ Grade: ________ Sex: ________

Parent/Guardian’s Name: ___________________________

Relationship to Child: _______________________________

Street Address: ____________________________________

City/State/Zip: ____________________________________

Cell Phone: _______________________________________

Email Address: ____________________________________

Work Phone: ______________________________________

Relationship of Deceased to the Child: ________________

Date of Death: _____________________________________

Child T-Shirt Size: __________________________________

Parent/Guardian’s Signature:

__________________________________________________

Date: _____________________________________________

Application

Tennova.com

Camp Willow Creek is a place where children and teens can find comfort and hope. It is designed for young people ages six to 16 who have lost a loved one to death in the past two years. The child must have turned six years old by January 1, 2017.

Camp Willow Creek provides a safe haven for youth to come together and share their pain, struggles, tears, hopes and dreams.

The Importance Of Helping Children GrieveExperts agree that failing to deal with childhood grief can have a profound effect on quality of life as an adult. Children grieve in small increments of time. They deal with what they can handle at the moment and then resume their normal activity.

Camp Willow Creek teaches these young people coping skills to grieve in a healthy manner through two groups:

Explorers: Ages 6 to 10

• Arts and crafts• Small games• Group sessions

Challengers: Ages 11 to 16

• Challenge course• Recreation• Group sessions

Explorers and Challengers will enjoy swimming, canoeing, fishing and eating meals together.

StaffCamp Willow Creek is staffed by trained volunteers through Tennova Hospice. Nurses are available on site, if needed.

CostThere is no cost to the participant at Camp Willow Creek. Round-trip transportation is also provided free. Camp is sponsored by Tennova Hospice and funded by the Tennova Healthcare Clarksville Volunteer Auxiliary.

FacilitiesCamp Willow Creek is held at Camp Brandon Springs, a retreat center located at Land Between the Lakes, 65 miles northwest of Clarksville.

Our Mission is to facilitate a child’s journey through grief in a safe, supportive, and healing environment.

I learned it’s okay

to cry.

One of the things I learned is there

are other kids like me.