Stroke retreat forms
To take part in the camp, you must fill out required forms and application below. Once we receive and review your materials, you will be notified of your acceptance. Respond as early as you can, because a full camp is expected. Applications are processed on a first-come, first-served basis. Those applications received after the maximum capacity is reached will be placed on a waiting list. Due to space and staffing limitations, it is possible that not all applicants will be accepted.
All of the following must be received before your application is considered:
- One General form for each person attending camp.
- One Camper Health History and Authorization or Camper Health History and Authorization short form for those who have an application on file from any stroke retreat since 2007.
- One Camper Application per family. Please note: There are three forms: Full weekend for overnight campers, day camp for those with other arrangements and Short Form for those who have an application on file from any stroke retreat since 2007. Please make sure you are completing the appropriate form. (Only one application per group needs to be completed if you are attending with family members, caregivers and/or companions.)
- One Release and Indemnification for each person attending camp.
- One Information Update for Returning Camper for each returning camper attending.
- One Camper Authorization to Contact Heath Provider & Health Care Provider Health Form for participants for each person attending camp; Only Part 2 is required for each person attending camp. Parts 1 and 3 of this form are required for all stroke survivors or any other participant with significant health issues. Part 3 must be completed by their health care provider, who should return the form to Henry Ford by mail or fax.
Return camper applications and health history forms as soon as possible, along with your payment, in order to complete your reservation for the stroke retreat. Also, each stroke survivor and any participant with a significant medical history must have his or her physician complete the Camper Authorization and Health Care Provider Form. This form also must be turned in before camp in order to attend.
Send your completed forms to:Kissie Harris
Clara Ford Pavilion 126
Henry Ford Hospital
2799 W. Grand Blvd.
Detroit, MI 48202
Or fax forms to (313) 916-8007.
Directions to Camp Cavell
Camp Cavell is located 25 miles north of Port Huron, Michigan, on Lake Huron, just past the town of Lexington and just north of Aitken Road.
Take I-94 east toward Port Huron. Take the Lexington exit and follow the signs to North M-25 (Lakeshore Road). The Camp Cavell entrance is on the right, 4.5 miles north of Lexington on M-25. Drive in through the gate and check in at the camp office.
Camp addressCamp Cavell
Lexington, MI 48450