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Teen Adventure Camp 2013 Application for Parents and Peer Mentors

Dear Parents and Peer Mentors,

We are excited to announce that we are accepting applications for the Lourie Center for Pediatric MS 10th Annual Teen Adventure Program. As a peer mentor you are expected to stay through BOTH sessions of camp, held this summer from July 6-13, 2013. The program will again be held at the Canonicus Retreat Center in Exeter, Rhode Island (details can be found at

The application form is available below. In order to be considered complete, your application package must include all signed consent forms in addition to the general information application. For your convenience, please refer to the attached checklist prior to sending your packet to ensure its completion. The deadline for all complete applications is May 3, 2013.
The medical form, completed by your physician, can be submitted separately, but must be received in our office by June 14, 2013.

Very limited transportation assistance is available. If you would like to apply for travel assistance, please include a written request with your application and we will do our best to accommodate those with a need.

Camp personnel will include staff from the Lourie Center for Pediatric MS, along with staff and volunteers from the National MS Society. Program professionals will be comprised of the Access-2-Adventure team of recreational therapists. All staff will be on-site throughout the week.

Please contact me at the Lourie Center for Pediatric MS with any questions about the program or application. I can be reached at 631-444-7802.

We look forward to our 10th Teen Adventure Camp!

Maria Milazzo, RN MS
Coordinator, Lourie Center for Pediatric MS

Stony Brook University Hospital
101 Nicolls Road Stony Brook, NY 11794
(631) 444-4000