December 31, 2015

Family Cancer Support Program

Family Cancer Support Programs

Camp Sparkle

Four weeks of free summer camp in Everett, Redmond, Seattle, and Tacoma. At Camp, kids ages 6-12 experience music, art, crafts, games, exercise, theater, therapy dogs, field trips and much more! Children may attend one week of camp per summer. Call 206-709-1400 or email info@cancerpathways.org for information about registering.

    Seattle - Monday, June 26th through Friday, June 30th

    Tacoma - Monday, July 10th through Friday, July 14th

    Everett - Monday, July 24th through Friday, July 28th

    Bellevue - Monday, August 7th through Friday, August 11th

Teens ages 16 and older can participate at Camp Sparkle by volunteering as a camp counselor! Counselors participate in special training and report to the Camp Director. For more information please call 206-709-1400 or email info@cancerpathways.org.

Family Support Program

Cancer Pathways offers support programs for families dealing with a cancer diagnosis. Kids and parents have the opportunity to express themselves in confidential groups led by experienced Art Therapists. Children can connect with others in their age group and participate in Art Therapy activities. This group is appropriate for children ages 5-12. The program also seeks to support parents who are handling a cancer diagnosis in the family. Parents meet separately for a parent networking group with a Licensed Clinician. These groups meet at the Cancer Pathways building in Seattle and are held on an as needed basis. The group typically runs for a 5 or 6 week time period. If you are interested in this program please complete this information sheet.

Special Events

Cancer Pathways hosts fun family social events throughout the year, including a Halloween Carnival, Holiday event, and Spring Carnival open to the general public.

Save the date for our next event: Halloween Carnival will be held on Friday October 27th from 6-8pm.






Your Name*:

I am a*: Person With CancerFamily Member/FriendVolunteerOther

Address*:

City*:

State*:

Zip*:

Phone 1*:

Land Line:

May we leave you phone messages?*
YesNo

Date of Birth*:

Sex*:
MFOther

Your Email*:

May we send you the monthly program calendar by email?*
YesNo

Occupation/Interests*:

Language (If not English, please specify):

How did you hear about Cancer Pathways?*

What is your medical diagnosis or the diagnosis of the person in your life who has/had cancer?*

Emergency Contact*:

Emergency Phone*:

Emergency Contact Relationship*:

Physician*:

Physician Phone*:

Hospital/Treatment Center*:

Family Members:

Spouse/Partner:

Do you have children under 18?*
YesNo

Please list your children here, Full Name, Sex, Age, and Date of Birth:

Cancer Pathways gathers information about every Participant to help us better understand who comes to our programs. All personal information will be kept confidential. Since we are a non-profit organization that does not charge for our services, we rely solely on donations to underwrite our programs. The following information would better help us to secure funding. The information provided to funders will only be in terms of combined demographic data of all Participants with no identifying information. Your answers to these questions will, in no way, affect your ability to access all programs at Cancer Pathways or other off-site locations at no charge.

Race/Ethnicity:

White (non-Hispanic)Black/African American (non-Hispanic)White-HispanicBlack-HispanicAmerican Indian/Alaska Native/First NationsAsian/Pacific IslanderOther

Insurance:

Medicare onlyMedicare + PrivateMedicaidPrivate InsuranceUninsured

Employment Status:
Employed full-time or part-timeOn medical leaveDisabledNot EmployedRetired

Are you interested in joining a support group?

For adults:
Living with Cancer Group for adults with any cancer diagnosis (Seattle, Federal Way, Bellevue)Caregiver Group (Seattle, Federal Way, Woodinville)Bereavement Group (Bellevue)

For Families:
Camp Sparkle 2017 for kids ages 5-12Family Support Groups (Art therapy for children 6-12 and networking for parents)Family fun eventsTeen Retreat (for teens ages 13-18)

Today's Date:

Signature

*Required

Click Here to View Our Monthly Calendar