Choose Your Team
Event Planning
Fill out the form for me
 Cochlear Implant Family Camp - June 13 - 16 2019
Cochlear Implant Family Camp: June 13th -16th 2019
Thursday, June 13, 2019
YMCA of the Rockies
2515 Tunnel Road, Estes Park, CO 80511
"Camp is for children aged 3-18 years old and their parents or legal guardians only. If you want to request an exception, please contact the Camp Director prior to registering."

Your information is safe. Blacktie does not sell or share any information about you or your purchase. In addition, you should see a little padlock in the corner of the screen. This indicates that this site is protected by a Secure Socket Layer and that your credit card information can't be intercepted as you enter it.

Fields with an * are required.
*Attendee's First Name :
*Attendee's Last Name:
*State: (ignore for non-US transactions)
*Zip Code:
*Country (if not US):
*Email Address:
*Confirm Email Address:

Prices for family registrations will increase $25.00 on January 1st 2019!

Number of Family of 2 Registration - at $500.00:
Number of Family of 3 Registration - at $550.00:
Number of Family of 4 Registration - at $600.00:
Number of Family of 5 Registration - at $650.00:
Number of Family of 6 Registration - at $800.00:
Requires 2 rooms
Family of 6 Registration include:
2 rooms for family of 6
Number of Family of 7 Registration - at $900.00:
Requires 2 rooms
Family of 7 Registration include:
2 rooms for family of 7
Number of Horseback Rider Registrations - at $33.00:
Number of Hayride Wagon Registrations - at $13.00:
Would you like to make a donation?
Please enter an amount:

(No commas or dollar sign please)
Did you know your registration fee only covers one-third the cost of camp? This is to ensure that camp is affordable for most families. If you are willing and able to pay more, please consider adding a charitable donation with your registration. Every gift, no matter the size, will help!
Your order total:
*What cochlear implants (and hearing aids) does your child wear?
*Do you own or use an FM system?
*How did you hear about camp?

Credit Card Billing Address
If the address where you receive the credit card bill is different than above, please enter it here.

Zip Code:
You will be asked to enter your guest names (if any) and answer any questions (if there are any), such as meal choices on the next page.
Credit Card  
For card readers, please put the cursor here:
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
C V V Value: What is CVV?
Yes, the organization sponsoring this event may contact me.

Refund Policy: Refunds Available until 4/12/19 less a $50 administrative fee.

Click here to see our privacy policy
Remember Me
If you attend a number of different events that use Blacktie for online registration, this will save your information for future events.
You must enter your email address (above) and choose a password.
Blacktie does not save your credit card information so you will need to re-enter that for each registration.
By checking this box, I want the system to remember me (except for credit card info)

Choose password:

You will receive a confirmation e-mail message with instructions.

By signing up for this service you agree that Blacktie may contact you from time to time.