Intent to Register

Or if you prefer, download, print and return our PDF brochure by mail, fax or email to:

Jane Jordan
Program Assistant
North Shore Palliative Care Program
Lions Gate Hospital 7 West, 231 15th Street East
North Vancouver, BC V7L 2L7

Tel: (604)984-3743
Fax: (604) 984-3798
e-mail:

PDFIf you have problems viewing the PDF, please download Adobe's free Acrobat Reader software!

Completing the web based
Intent to Register form on this page is the easiest way to express your Intent to Register for Camp Kerry.

Upon receiving your registration information, you will be contacted by the Bereavement/Camp Coordinator for a brief interview (by phone or in person) to determine if Camp Kerry is suitable for your family.

A full registration package will becompleted at that time.

Space is limited so call soon!

Intent to Register Online Form

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