About Us
Programs
Camp FAQs
Family Camps
Overnight Camps
Day Camps
CSH1Days
Counselor-in-Training (CIT)
Diabetes WALKs
Resources
Photos
Events
Alumni
E-News Archive
Research Opportunities
Scholarship
Store
Programs Map
Contact
Register
Donate
Contact Us TEST
New
Volunteer
General
Information
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Message
(Required)
Your Name
(Required)
First
Last
Preferred Method of Contact
Email
Phone
Text
Your Email Address
(Required)
Email Address
Confirm Email Address
Cell Phone Number
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Do you have a child (18 or younger) with diabetes?
(Required)
Yes
No
In order to best serve your child with diabetes and family, please share your child's name and date of birth. This information helps us to provide you with the best information and programs that would be appropriate for your child.
Name of Child with Diabetes
Birthdate of Child with Diabetes
MM slash DD slash YYYY
What is your interest in Camp Seale Harris (check all that apply)?
(Required)
I would like to get Camp Seale Harris's e-news delivered to me.
I want information about Camp Seale Harris programs for my child/family member (camps, support, activities).
I want to donate to Camp Seale Harris.
I used to attend Camp Seale Harris.
Your Comments/Questions
By submitting this form, you are consenting to receive marketing emails from: Southeastern Diabetes Education Services, 500 Chase Park South, Suite 104, Birmingham, AL 35244.
Stay Updated
Newsletter Sign Up
Get Connected