SoCal Camp Registration

2024 Camp Information

Memorial Day Weekend – May 24-27, 2024 – General camp info

• Family Registration — January 10 – April 30

Volunteers, Speakers, and ASL Interpreters: Register January 10 – April 30

Members Save at Camp

Did you know that California Hands & Voices members save per person to attend Family Camp? If you are not a member of CA H&V, we invite you to join while registering today for just $25 AND instantly qualify to pay the discounted member rate for camp fees.

Registration Form

Please enable JavaScript in your browser to complete this form.

Is someone in your family group a current CA H&V member? *

• Yes, a parent in our family is already a member
• Not currently, but I’d like to become a member (or renew) and pay member rates for camp**
• No, and I prefer to pay the non-member rates
• N/A, I am a speaker / interpreter

**Join CAH&V today for $25 to instantly qualify for the discounted member rate.

Family Contact Information

Family Last Name *

Family Primary Email *

Family Primary Phone *

I agree to have my contact information included on the camp attendee roster *

• Yes
• No

Photo release *

• I acknowledge our family may be photographed and/or videotaped by staff during Family Camp. I understand the photographs and/or video may be used for informational, promotional or instructional purposes.

Family Address

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

County *AlamedaAlpineAmadorButteCalaverasColusaContra CostaDel NorteEl DoradoFresnoGlennHumboldtImperialInyoKernKingsLakeLassenLos AngelesMaderaMarinMariposaMendocinoMercedModocMonoMontereyNapaNevadaOrangePlacerPlumasRiversideSacramentoSan BenitoSan BernardinoSan DiegoSan FranciscoSan JoaquinSan Luis ObispoSan MateoSanta BarbaraSanta ClaraSanta CruzShastaSierraSiskiyouSolanoSonomaStanislausSutterTehamaTrinityTulareTuolumneVenturaYoloYubaOut of State

Camper Information

Youth T-shirts are included in registration // Adult T-shirts can be added-on at end of this form for $13/shirt

How many family members will attend? *123456

Families must register together to be placed in same lodging

# Campers (hidden)

Camper #1

Camper #1 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Camper #2

Camper #2 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Camper #3

Camper #3 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Camper #4

Camper #4 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Camper #5

Camper #5 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Camper #6

Camper #6 Name *

First

Last

Age of this camper on 1st day of camp *Select age…Infant123456789101112131415161718+

Date of Birth *

MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Camper Type (member rates) *Choose one…Weekend Camper – $175.00Saturday Day Camper – $125.00

Camper Type (infant) *Child Under the Age of 1 – $0.00

Camper Type (speaker, interpreter) *Speaker / Interpreter – $0.00

Camper Type (non-member rates) *Choose one…Weekend Camper – $195.00Saturday Day Camper – $145.00

Audiologist who works with this child (optional)

First

Last

Audiologist's Email

DHH Teacher who works with this child (optional)

First

Last

DHH Teacher's Email

T-shirt Size *Select size…Child XS (2-4)Child S (6-8)Child M (10-12)Child L (14-16)Adult SAdult MAdult LAdult XLAdult 2XLAdult 3XL

Youth, Speaker, and Interpreter T-shirts are included in registration.

Gender *

• Female
• Male
• Non-binary

Hearing Status *

• Deaf
• Hard of Hearing
• Hearing

Interpreter Needed *

• No
• Spanish
• Sign Language
• Other

We will do our best to accommodate

Has a severe allergy (bee / peanut etc.)? *

• No
• Yes

Describe symptoms we will notice if allergen is encountered (copy) *

Provide a specific Action Plan if allergic reaction occurs *

Special needs *

• No
• Yes

Including but not limited to Autism, ADHD, motor or orthopedic disabilities, Deaf/Blind, low vision, etc.

Describe special needs *

Please help us provide a safe experience

Uses 1:1 aid daily at school *

• N/a (for adults)
• No
• Yes

Describe your child's personality, strengths, challenges, fears and or any separation anxiety that they may experience while at Family Camp. Please also include tips and strategies that will be helpful.

Please help us support your child at camp.

Additional Information

Is there another family you would like to lodge with?

• No
• Yes

Which family? *

NOTE: We will do our best but cannot guarantee placement

Are you interested in volunteering for California Hands & Voices in addition to attending Family Camp?

• Yes, I’d love to help
• No, not right now

Does anyone in your family have medical certifications/training (e.g., CPR certification)?

If so, please list person’s name and their qualifications

How did you hear about camp? *Select one…CA H&V eblastFriend/familyTeacher / TherapistMedical ProfessionalInternet SearchOther

I am presenting / interpreting on…

• Friday
• Saturday
• Sunday

Please select as many days as applicable

Please select all applicable (speakers only):

• I agree to send my PowerPoint to the planning committee for review no later than April 15th
• I do not plan to have a PowerPoint presentation
• I will provide my own computer and the wires necessary to connect to the projector
• I require a computer to show my presentation

CAH&V Mission

California Hands & Voices is dedicated to supporting families with children who are Deaf or Hard of Hearing in a respectful and non- judgmental manner regarding language opportunities, communication tools or educational approaches

Please tell us, in your own words, what our mission (in part) means to you:

Camp Registration Total Payment

Purchase additional T-shirts *

• No thanks
• Yes please

T-shirts are complimentary for campers under the age of 18, speakers, and interpreters

# of Additional T-shirts *1234

$15/shirt

List Sizes for Additional T-shirts – Child (XS 2-4, S 6-8, M 10-12, L 14-16) / Adult (S, M, L, XL, 2XL, 3XL) *

Separate with commas – e.g., for 3 shirts: “Adult S, Child L, Adult XL”

Camper Fees

Price: 0.00

Total for all family members

Annual Membership

Price: $0.00

Applies to New / Renewing CAHV Families only

Additional T-shirts

Price: $0.00

Youth, speakers, & interpreters receive FREE shirts

Add a Donation

We appeal to any family who can to make a donation (no amount is too small) when registering. This supports us to offer the camp at a rate which is lower than we are charged.

Coupon

Apply

GRAND TOTAL

$0.00

Register & Pay

We process our payments through PayPal. Once you click Register, you will be taken to PayPal to complete your camp registration and pay the total amount listed here. You will then be returned to our site.

Pay by Check

• I prefer to pay by mailing a check

Before submitting, please confirm BOTH of the following: *

• I confirm the T-shirt sizes are correct for each camper.**

** Unfortunately we are not able to switch T-shirt sizes after order is placed

Fees are non refundable *

• I understand that camp fees are nonrefundable, non transferable, and cannot be used for future events.

Complete Registration