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DTSTART;VALUE=DATE:20250710
DTEND;VALUE=DATE:20250728
DTSTAMP:20260405T092421
CREATED:20250303T142323Z
LAST-MODIFIED:20250521T171245Z
UID:10916-1752105600-1753660799@www.nextstepnet.org
SUMMARY:2025 Summer Campference
DESCRIPTION:We are hosting two different sessions of our FREE residential Summer Campference program for young people\, ages 16-24\, living with a chronic illness at the Warren Conference Center and Inn in Ashland\, MA. Part camp\, part conference\, our 4-day Summer Campference fosters friendships and community with peers who “get it.” At a Next Step Summer Campference\, you can: \n\nEngage in educational workshops\nRecharge with new friends\nJoin the music and art mayhem\nCreate fun\, life-changing moments\nEmpower yourself with information and resources\n\n\n					\n\n					\n					\n				\n			\n				\n\n						\n\n						\n\n						\n\n						\n\n						\n\n						\n\n						\n\n						\n\n						\n\n						\n			\n\n			\n\n			\n  \nWhich session is best for you this summer? \nSession 1: Thursday\, July 10th to Sunday\, July 13th \nSession 2: Thursday\, July 24th to Sunday\, July 27th \nSpots for our popular Summer Campference fill up fast so we encourage you to submit your application below as soon as possible to secure your spot! \n  \nIn Their Words \nOur participants say it best. Read stories from young people who have attended a Next Step Campference. \n  \nDo you have questions before signing up? \nEmail Kepler Jeudy\, Next Step Program Director\, at kepler@nextstepnet.org if you have any questions about our 2025 Summer Campference program for young people living with a chronic illness. \n  \n\n\n                \n                        \n                            2025 Summer Campference Application\n                            Please fill out this application if you are interested in joining our Summer Campference. \n                        \n                        Which session are you interested in?*\n								\n								Session 1: July 10-13\n							\n								\n								Session 2: July 24-27\n							We are hosting two different sessions of our Summer Campference program for teens and young adults\, ages 16-24\, living with a chronic illness. This program will be held in Ashland\, MA at the Warren Conference Center & Inn.Have you been to a Next Step Program before?*\n			\n				\n				Yes\n			\n			\n				\n				Attended Introductory Event Only (e.g. Next Step Mobile at hospital\, community center\, etc.)\n			\n			\n				\n				No\n			How did you hear about the Next Step campference?*\n			\n				\n				Next Step Outreach (Email or Event)\n			\n			\n				\n				Google/Internet Search\n			\n			\n				\n				Social Media (Instagram\, etc.)\n			\n			\n				\n				Family Member/Trusted Adult\n			\n			\n				\n				Another Participant\n			\n			\n				\n				Medical Staff\n			\n			\n				\n				Other\n			\n			\n				\n				\n			If medical staff\, please include name\, position and hospital:*Name*\n                            \n                            \n                                                    First\n                                                    \n                                                \n                            \n                            \n                                                            Last\n                                                            \n                                                        \n                            \n                        NicknameAddress*    \n                    \n                         \n                                        Street Address\n                                        \n                                   \n                                        Address Line 2\n                                        \n                                    \n                                    City\n                                    \n                                 \n                                        State\n                                        AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific\n                                      \n                                    ZIP Code\n                                    \n                                \n                    \n                Phone*Alternate PhoneEmail*\n                            \n                        Preferred mode of contact?*\n								\n								Email\n							\n								\n								Cell Phone (Call)\n							\n								\n								Cell Phone (Text)\n							Current OccupationEmployer or SchoolAgeBirthday\n                            \n                            MM slash DD slash YYYY\n                        \n                        Race/EthnicityGenderPronouns (he/him\, she/her\, they/them)What is the highest level of education you have received so far?T-shirt sizeHospital or Clinic where you receive medical care?What do you hope to get out of the Next Step campference experience?What topic(s) do you most want to learn about at Campference?PARENT/GUARDIAN AND EMERGENCY CONTACTName*\n                            \n                            \n                                                    First\n                                                    \n                                                \n                            \n                            \n                                                            Last\n                                                            \n                                                        \n                            \n                        RelationshipPhoneEmail\n                            \n                        Medical OverviewDiagnosisDate of Diagnosis\n                            \n                            MM slash DD slash YYYY\n                        \n                        Are you on active Treatment?\n			\n				\n				Yes\n			\n			\n				\n				No\n			Food Allergies & ReactionsEnvironmental Allergies (bee\, latex\, etc) & ReactionsDo you carry an Epi-Pen?\n			\n				\n				Yes\n			\n			\n				\n				No\n			Are there are any special accommodations you would need (dietary\, mobility\, equipment\, etc.)? Please explain:Are there any activity limitations?Please list any medications you take\, and how often.Please take a moment to describe what symptoms you display if you’ve overextended yourself or are starting to get sick. How can we best support you in such a situation?INSURANCE INFORMATION(Please bring your insurance card to the program)Insurance Co:Policy #:Name of Insured:\n                            \n                            \n                                                    First\n                                                    \n                                                \n                            \n                            \n                                                            Last\n                                                            \n                                                        \n                            \n                        PrescriptionPlan #:Telephone #:Over the Counter Medications: I—or my child\, if under the age of 18—has permission to take over-the-counter medication\, for the dosage amount suggested by the pharmaceutical maker\, if feeling unwell due to symptoms such as headache or stomachache.  Please check appropriate boxes and provide your signature below:I—or my child\, if under the age of 18—may take over-the-counter medication that I brought:*\n			\n				\n				Yes\n			\n			\n				\n				No\n			I—or my child\, if under the age of 18—may take OTC medication provided by a staff person:*\n			\n				\n				Yes\n			\n			\n				\n				No\n			I—or my child\, if under the age of 18—should not\, under any circumstances\, be given the following OTC medications:Please indicate:*\n			\n				\n				I consent\n			\n			\n				\n				I do not consent\n			CONSENT AGREEMENTAUTHORIZATION AND RELEASE\nThis Consent Agreement\, Authorization and Release must be read and signed to be eligible to attend Next Step's Young Adult Campference.\n\nRELEASE OF LIABILITY\nI understand that occasionally accidents occur during campference activities and that participants may sustain serious personal injury and property damages as a consequence thereof. Knowing the risks of campference activities\, nevertheless\, and in consideration of my acceptance for participation at a campference\, I hereby agree to assume those risks and to hold harmless Next Step\, and all campference agents\, representatives\, employees and volunteers\, from any and all liability\, claims for personal injury and/or property damage\, costs\, expenses and damages arising out of or connected in any way with my participation in campference activities. Further\, I acknowledge that Next Step accepts no responsibility for the loss\, damage or theft of my personal property.\n\nI acknowledge and understand there is an increased risk that communicable illnesses can be transmitted in any public place\, including an in person Next Step program. Next Step seeks to protect its staff and participants during any and all in person activities. By attending a Next Step in person program\, I agree to assume these risks.\n\nAdditionally\, as a precondition to participating in a Next Step program I understand to participate in person I must be up to date on my vaccinations against Measles\, Mumps\, Rubella\, Varicella\, and Pertussis (unless medically exempt with a doctor's note). I must also have my provider complete a medical application every 12 months to participate in person at a Next Step program.\nPlease indicate:*\n			\n				\n				I consent\n			\n			\n				\n				I do not consent\n			CONSENT FOR MEDICAL TREATMENTThe undersigned hereby grants permission to the medical staff or consulting physicians at Next Step to administer medication and provide medical care for me\, including any medical emergency care required. I also give my consent for any emergency transportation deemed necessary.Please indicate:*\n			\n				\n				I consent\n			\n			\n				\n				I do not consent\n			Community Agreement/Rules of ConductThe young adult campference is a close-knit community; therefore we ask that you agree to a few things that will promote being together in a safe manner. Please sign this Community Agreement\, which asks that you agree to conduct yourself ethically and respectfully while living in the program: \n\n\nDelegates are to demonstrate a high degree of maturity and self-respect\, taking into account the rights and feelings of others.\nDelegates are responsible for charges incurred\, e.g. vandalism and breakage of property\, etc.\nDelegates are to adhere to curfews\, directives and designated schedule times.\nSuitable attire is to be worn during the campference workshops and activities.\nSmoking is prohibited indoors.\n\nThe Following Behaviors are grounds for Immediate Dismissal: \n\nPhysical confrontations or assaults. This means harming\, attempting to harm\, or threatening to harm another person\, with or without a weapon or dangerous object\nBullying. As defined as unwanted\, aggressive behavior that involves a real or perceived power imbalance. The behavior is repeated\, or has the potential to be repeated\, over time. Verbal bullying is saying or writing mean things. Social bullying involves hurting someone’s reputation or relationships and can include leaving someone out on purpose\, telling other’s not to be friends with an individual\, spreading rumors\, embarrassing someone.\nStealing or damaging property\nPossession or use of drugs and alcohol\nSexual misconduct or sexual assault\nPlease indicate:*\n			\n				\n				I agree to the community agreement\n			\n			\n				\n				I do not agree to the community agreement\n			PHOTO AND INFORMATION RELEASEI give Next Step permission to photograph and use pictures or visual and/or audiotapes of me in professional or fundraising activities. On occasion\, with this permission\, participant photographs may be included on the Next Step website\, on a bulletin board\, video\, newsletter\, campference album\, or in personal photographs.  Next Step respects the privacy of participants and does not allow unauthorized visitors to photograph the campference or participants.  In addition\, by signing below\, I give Next Step permission to give my name\, address and/or phone number to groups or individuals wishing to support Next Step by inviting me to an event or by sending me information related to Next Step. This list will not be sold or given to anyone else for any other reason.Please check appropriate box and provide your signature below:*\n			\n				\n				I agree to the photo release\n			\n			\n				\n				I do not agree to the photo release\n			Please SignBy signing below\, I hereby acknowledge that I have read and fully understand the terms and expectations of the program. All information provided is current and accurate to the best of my knowledge. Name*\n                            \n                            \n                                                    First\n                                                    \n                                                \n                            \n                            \n                                                            Last\n                                                            \n                                                        \n                            \n                        Date*\n                            \n                            MM slash DD slash YYYY\n                        \n                        Please check this box to indicate that the above signature will serve as your electronic signature\n								\n								(Delegate or Legal Guardian if the Delegate is not over the age of 18)\n							\n          \n            \n            \n            \n            \n            \n            \n            \n            \n            \n            \n            \n            \n            \n        \n                        Δ
URL:https://www.nextstepnet.org/event/2025-next-step-summer-campference/
CATEGORIES:Cancer,HIV,Program,Rare Genetic Disorder,Sickle Cell
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