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Camp Application for Gold Ribbon Accreditation Visit
Camp Application for Gold Ribbon Accreditation Visit
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
This program is proudly sponsored by Care Camps Foundation and would not be possible without their support.
Camp Name
*
Camp Director's Name
*
First
Last
Cell Phone
*
This number will be used for visit contact purposes and to send codes to authenticate your login for Portal access to upload documents and add comments/questions for the visitors.
Email
*
Is your Camp Director different than your Gold Ribbon Contact?
*
No
Yes
Gold Ribbon Contact Name
First
Last
Email
Cell Phone
If assisting with Portal documentation, this number will be used to send codes to authenticate your Portal login access.
Alternate Gold Ribbon Contact
First
Last
This could be a second contact for day of visit or assisting with document upload to the Portal.
Alternate Gold Ribbon Contact's Role/Title
Cell Phone
This number will be used for visit contact purposes and to authenticate your login for Portal access to upload documents and add comments/questions for the visitors.
Email
Location of Camp Visit
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
--- Select country ---
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Are there any special instructions our visitors should know about to locate your camp site facility? (I.e. must take a ferry, pick up location, etc.)
Is this camp currently Gold Ribbon recognized?
*
No
Yes
Do you own or rent the camp site facility?
*
Own
Rent
Other
Is your camp facility accredited by:
ACA
OCA
CCCA
Not Accredited
Other
Are your camp programs accredited by:
ACA
OCA
CCCA
Not Accredited
Other
At our camp session(s), the populations served may include:
Patients only
Patients and Siblings
Family Campers
Other
Type of camp:
Residential Overnight
Family Camp Weekend
Day Camp
Other
Please list the 2025 camp session dates in which you are willing to have a visit. (Please only put dates where patients are attending, and do not put check-in or check-out dates.)
Once a date is determined based on visitor availability, the date will be confirmed with the camp before it is confirmed with the potential visitors. Please put the first date for session one that is an option for visitors in the "Session 1 Begin Date" section. The "Session 1 End Date" section is for the last available date of your first session. Please be advised that any dates that fall in between the two listed dates will be considered unless otherwise noted.
Session 1 Begin Date
*
Session 1 End Date
*
Are there any dates that fall between your stated beginning and end date that you cannot host a visitor? (Example: a day you are going on a field trip, have another visitor, etc.)
Would You Like to Add Another Session?
No
Yes
Session 2 Begin Date
Session 2 End Date
Are there any dates that fall between your stated beginning and end date that you cannot host a visitor? (Example: a day you are going on a field trip, have another visitor, etc.)
Would You Like to Add A 3rd Session?
No
Yes
Session 3 Begin Date
Session 3 End Date
Are there any dates that fall between your stated begin and end date that you cannot host a visitor? (Example: a day you are going on a field trip, have another visitor, etc.)
Is there a dress code for visitors?
*
No
Yes
Dress Code:
Does your camp have internet service?
*
No
Yes
Visitor Travel and Lodging
Can the camp provide visitors lodging?
*
No
Yes
Maybe, will know closer to visit date
COCA is trying to be mindful of expenses for visitors and hopes to save money for Care Camps Foundation for these visits.
If lodging is unavailable for the visitors, plese suggest other lodging options.
What is the closest airport to the campsite?
*
Can the camp provide visitors transportation to and from the airport?
*
No
Yes
Anything else we should know about when scheduling your visit?
(ie-vaccinations, health screening, etc.)
Mandatory Training
Mandatory Training will be a course on our Professional Development Learning Center, followed by an optional Q&A Zoom.
Mandatory Training will include understanding what documentation is needed to meet each Standard and important deadlines.
COCA Gold Ribbon Visit Camp Agreement
As the contact person on the day of the visit I agree to the following:
Participate in the MANDATORY camp training course:
*
I agree
Upload my camps policies to the COCA Gold Ribbon Portal by the stated deadline:
*
I agree
Recognize that failure to comply with the above items may result in forfiture and cancellation of scheduled Gold Ribbon visit:
*
I agree
Signature
*
Clear Signature
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Submit
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