Applications are now open for
Camp Moja 2023!
Camp Moja 2023 will be $350.00 The cost includes the $50 deposit due at the time of registration.
Campers must be:
- 18 years or older
- Able to independently to toilet themselves
- Able to walk 1/4 miles without assistance, or with assisted devices
- Not be an active choking risk
- Not had a violent outburst in the past year
If you have any questions about the above, please email campmoja@gmail.com before registering.
If you sign up and are placed on the waitlist, we will let you know if a spot opens up!
AFTER you complete registration please have the guardian fill out the following form:
If the guardian is a PA, please email campmoja@gmail.com once you’ve registered, as a separate release will be sent to them.
Before registering- please have the following information at hand:
- Recent photo of camper (will need to be uploaded to ACTIVE site – shoulders and up only please).*
- Photo/copy of the insurance/Medicaid card (will need to be uploaded to the ACTIVE site).*
- What time of day does the camper take meds (Breakfast, lunch, dinner, bed)
- How many medications/supplements per day does the camper take
- Camper T-shirt size
- Degree of camper’s intellectual disability (mild, moderate, or severe)
- Camper’s diet (regular, vegetarian, gluten-free or dairy-free)
- Has/is the camper
- Had a fall in the last 90 days
- A violent outburst in the last year
- A tetanus shot in the last 10 years
- Diabetic
- Have seizures
- Take seizure medication
- Name, phone, email of 2 emergency contacts that are available to pick the camper up at any point of an emergency
- Name, phone, email of the person for whom the medical registration should be sent (this should be the parent who lives with the camper, a QDDP/Case Manager, or house manager. not the camper)
- Name, phone, email of the person (legal guardian or camper who is their own guardian) who will need to sign the waivers
Optional information to have on hand:
- Does the camper have a roommate/counselor preference?
- Does the camper have a talent for the talent show already picked out (if so, what)
*these items are required, but not at the time of registration.
If you have any questions or are unsure of how to answer any of the registration questions please email us at campmoja@gmail.com
Moja Love, Cris and Johnny
