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Registration Forms

Camp Chihopi
August 13-16, 2015

If your child would like to attend Camp Chihopi, please download and complete the following forms and mail, email, or fax them by the indicated date.

The following forms and information are included:

2015 Forms (PDF) Due Date
Registration Form July 6
Liability Release/Parental Consents July 6
Camp Rules and Contract July 6
Medication List July 6
Additional Medical Needs July 6
Media Consent July 6
Travel Plan July 27

Send the above forms to:
Beverly Kosmach-Park
Children’s Hospital of Pittsburgh
Faculty Pavilion, 6th Floor
Abdominal Transplant Surgery
4401 Penn Ave.
Pittsburgh, PA 15224
Fax: 412-692-6116
E-mail: beverly.kosmach@chp.edu

For questions or concerns, contact Beverly Kosmach-Park at 412-692-6115 or e-mail beverly.kosmach@chp.edu.

Last Update
February 26, 2015
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Last Update
February 26, 2015