Contact Us: 734-712-3456

Registration Deadline: June 1, 2016

Ages 6 – 17 Years – 10:00am
Saturday, July 30 – Noon Sunday, July 31, 2016

Step 1: Download and print the Camp Courage Application Packet. This packet includes the follow forms:

  • Camper Application (2 pages)
  • Consent and Release (1 page)
  • Howell Conference & Nature Center Agreement to Participate for Minors (1 page)
  • Camper Health History (1 pages)
  • Authorization for Emergency Medical Treatment (1 page)
  • Permission to Administer Over-the-counter Medication (1 page)
  • Camper Loss History (2 pages)
  • Camper Custody Release (1 page)

Step 2: The parent or legal guardian must complete, date and sign all the forms where indicated for each child/teen who will attend camp. Please fax to 734-327-3320 or mail to:

Brenda Rubin, Camp Coordinator
St. Joseph Mercy Hospice
Washtenaw Medical Arts Building 
3075 Clark Road, Suite 200 
Ypsilanti, MI 48197

Step 3: When we have received your completed forms, we will contact you to schedule an appointment to discuss further details of the camp.

Step 4: If your child/teen will be taking prescribed medications during the camp weekend, you will be given a Medication Order Form to have your physician complete and sign.

Registration Deadline: June 1, 2016 - Please note that applications are reviewed in the order they are received. Once we have reached capacity for the camps, additional applicants will be placed on the Wait List. Late applicants can call for space availability.

If you have any questions or concerns, please contact Brenda Rubin, Camp Coordinator at 734-327-3224 or