Youth Registration

DESTINY’s Extreme Weekend For Children with Diabetes

May 5th – 7th 2017
Ages 8 – 17 Boys & Girls

 

Registration for 2017 Youth Extreme Weekend is full. We are accepting registration on a wait list.

For Youth Extreme Weekend click HERE to sign up. If we have any cancellations we will contact you immediately and let you know we have an opening.

All of the forms must be filled out in pen and printed neatly.
All checks must be made out to Diabetes DESTINY.

Upon filling out the form you’ll receive a confirmation usually within 24 hours.
Also once the online form is completed please use the PayPal button below to complete the application process, you still need to fill out and mail in the Heath History Form, Parent Consent Form, and the North Bay Health Release.  You can find links to these forms below.

If you need financial assistance, please email us or call us so we can make sure your family are able to attend this program.

This is a two step process BOTH STEPS MUST BE COMPLETED!!.

STEP 1:  NEW: Electronic Camper Application Form can be accessed here.


NOTE: After the application has been submitted you should receive an email confirming your application was received within 24 hours. 

STEP 2: Payment: $250 for Spring 2017

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All campers/athletes must send (Please note new mailing address for forms): John Boyer, Diabetes DESTINY, 15106 Black Ankle Rd, Mount Airy MD, 21771 410-858-8646

Please fax the health history form to:

Diabetes Destiny c/o

 Jennifer Anisko, CRNP at UMCDE

Fax number 410-856-3847

Or Mail to:

Diabetes Destiny

15106 Black Ankle Road

Mount Airy MD, 21771

Northbay Required Health Release:

What To Bring