Camp Courage

Camp Courage Registration

Five Star Life Programs at SUMMIT - 2026
Registration Availability is Limited!

First Come, First Claimed!

Camp Courage is bringing connection, support, fun, and respite for families who have had an immediate Family member Battle cancer, another serious illness, or grief at our experiential learning campus. This opportunity at Summit includes our character, leadership, and mindset curriculum along with our experiential learning centers, and meals, bringing families a beautiful camp experience.

This is a free camp at Summit, with lodging and meals provided. We invite you to come and enjoy our beautiful facilities and experience all that Summit has to offer!

Through this day, we want to serve your family and bring you happiness, support, and connection! Apply to participate!

Date(s) and Times:
- Overnight Adventure:
  - Friday, August 14th - Saturday, August 15th
  - 4pm (Fri.) - 5pm (Sat.)
  - Open to the First 7 Families to Register
  - Maximum of 6 people per family unit
- One-Day Adventure:
  - Saturday, August 15th
  - 9:30am - 4:30pm
Cost: FREE!

Ages: All family members in attendance must be entering 3rd grade or older

Who: Families who have had an immediate member of the family experience cancer, another serious illness, or grief (limited to immediate family).

Five Star Life Office: 574.266.4038

Email: events@fivestarlife.org
How many family members will be attending and participating within your family unit?
Enter a Number
Please list out all family members that will be participating in the day, listing names, ages, and t-shirt size.
e.g., John Doe, 34, Large
Please share how and why you believe your family would qualify for this camp experience.
Parent/Guardian Information
Parent/Guardian

First NameLast Name
Phone Number
Format: (000) 000-0000.
Parent/Guardian E-mail (this is used to send updates with schedules, events and curriculum)
Address (Primary Residence)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact

First NameLast Name
Emergency Contact Number
Format: (000) 000-0000.
Health History

Please complete for the entire family unit. If anything needs to be explained, note the name(s) of the family member(s) that the note will apply to.
NOTE: All PARTICIPANTS must have an up-to-date signed Health History Form as well as Assumption of Risk, Liability Release, Indemnity Agreement, Picture and Video Waiver and Release to participate in any leadership experience at Summit.

PLEASE READ AND ANSWER THE QUESTIONS BELOW: This form is intended to remind leaders and participants of the seriousness of attempting adventure activities with an old preexisting injury, a heart condition, or other condition which might be aggravated by the event. Please connect with a Summit facilitator if you need to share any additional and pertinent information.
1. Any preexisting injuries (ankle, neck, back, knee, wrist, shoulder, etc.) that might be aggravated by participating?
Explain.
2. Taking any current medications?
Explain.
3. Any heart problems or medications?
Explain.
4. High blood pressure?
Explain.
5. Any allergies (bees, insects, medications, etc.)?
Explain.
6. Any physical limitations?
Explain.
7. Any special dietary needs?
Explain.
8. Current level of activity back at home?
Please include any additional information that you feel is relevant.
8. Immunization status up-to-date?
Please include any additional information that you feel is relevant.
9. Any other special health or behavioral considerations?
Please include any additional information that you feel is relevant.
Emergency Medical Release

Applies to the entire family unit
Liability Release

Applies to the entire family unit
Parent/Guardian Signature
Program Selection

Select which program option your family will be participating in.

Camp Courage Overnight AdventureFree

Friday, August 14th (4pm) - Saturday, August 15th (5pm). Limited to the first seven families to register for this option. Please select this option if your family would like to take part in the Friday-Saturday Overnight Adventure Option

Camp Courage One-Day AdventureFree

Saturday, August 15th (9:30am-4:30pm). Not one of the first seven families to register? No available for the overnight portion? Don't worry!! Please select this option and your family can join for the full day Saturday portion of the camp for an amazing experience!!

Donation Opportunity$25.00

Donate to the Five Star Life Scholarship Fund to Help Other Students in Need. Scholarship donations are in $25 increments, spanning from $25-$250 depending on the quantity selected. For donations over $250, please directly contact the Five Star Life central office at the phone number listed below to learn how you our your business can become a sponsor.

Quantity
Item subtotal:

Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

ACH Bank Transfer

Please note: dates/programs are subject to change based on enrollment and availability. If changes occur, you will be notified in advance.

Questions? Call us at 574.266.4038 or email us at events@fivestarlife.org
Should be Empty:

Camp Courage Registration

Parent/Guardian Information

Health History

Emergency Medical Release

Liability Release

Program Selection

Select which program option your family will be participating in. *

Payment Methods

Select which program option your family will be participating in.