Make a Reservation - Nonprofit, Free Pediatric Cancer Retreat for Kids

Apply here for a weekend at Chapel Hill House

Reservations can begin on Tuesday afternoon with checkout being on Thursday afternoon or Friday afternoon with checkout being Sunday afternoon.

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Available

Booked

Pending

Parents/Guardians Names(required)*:

Address*:

City*:

State*:

Zip*:

Phone*:

Email*:

Is your child currently being treated for cancer*:

Child 1 Name*:

Child 1 Age*:

Is Child 1 a patient?*:

Child 2 Name:

Child 2 Age:

Is Child 2 a patient?:

Child 3 Name:

Child 3 Age:

Is Child 3 a patient?:

Child 4 Name:

Child 4 Age:

Is Child 4 a patient?:

Additional Guest Staying & Their Relationship:

Does anyone have any physical restrictions or special needs?*:

Physician Name*:

Physician Address*:

Physician Phone Number*:

Address*: