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HERC Day Camp
828 Innes Ave.,
Suite 110

2 Cameron Way
San Francisco, CA 94124

Day Camp Application

Asthma Camp - HERC offers free day camps for children ages 6-14 who have been diagnosed with asthma and want to learn more about managing their condition.

A licensed professional teaches the children asthma management techniques and ways to recognize triggers and symptoms. Other subjects are: asthma action plans, exercise, nutrition, and building self-esteem. Each camp serves approximately 10 children.

Space is Limited - APPLICATIONS ARE PROCESSED ON A FIRST COME, FIRST SERVED BASIS

Fill out this form and send in, or call the Asthma Department at 401-6810

All contact * information must be filled in

Your First Name * Initial: Last Name *

Street Address * Apt.

Zip Code *

Home Phone * Other

E-Mail

Child's First Name * Initial

Last Name *

If child's address is different from yours:

Child's Street Address Apt.

Zip Code

Special Needs