Families Can♥Sur♥Vive: December 6-8, 2013

Started in 1995, Families Can♥Sur♥vive weekend provides families with an interactive opportunity to regroup, refocus, and renew. 

At Families Can♥Sur♥vive weekend, held this year at Bellows Air Force Station (map), children with cancer and their parents, brothers, and sisters learn the power of love and cooperation. Experienced directors and counselors guide discussions and activities focused on allowing families to discover their individual and family strengths while encouraging trust, open communication, and the development of problem-solving skills.

Families Can♥Sur♥vive is offered at no charge to the families with children (infant-18 years old) diagnosed with cancer. Families must be from Hawai‘i, Guam, or other Pacific Islands and registered with their local American Cancer Society field office. For Neighbor Islanders, air and ground transportation is also covered. Space is limited with preference going to those who have been recently diagnosed with cancer or are still in active treatment.

CLICK HERE to print and mail your registration form, or SUBMIT the form below to register online.

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Child's Name(required)

Birth date(required)

Age(required)

Sex(required) Male Female

Date of Diagnosis(required)

Type of cancer(required)

Parent(s) or Guardian(s)(required)

Address(required)

City and Zip(required)

Resident Island/Territory(required) Oahu Maui Molokai Lanai Big Island Hawaii Kauai Guam

Home Phone(required)

Work Phone

Cell Phone

Email Address(required)

Doctor's Name(required)

Doctor's Phone(required)

Hospital(required)

Insurance(required)

Policy Number(required)

Emergency Contact(required)

Relationship(required)

Phone(required)

Special Accommodations

Specific Dietary Needs

Please use the space below to add any family members, Relationship, Age, and T-Shirt size

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For more information please contact Debra Glowik:

American Cancer Society Hawai‘i Pacific
Childhood Cancer Programs
2370 Nu‘uanu Avenue
Honolulu, Hawai‘i   96817

Office: (808) 432-9105
Neighbor Islands: 1-888-227-7107, ext 105
Cell: (808) 489-7425
Email: debra.glowik@cancer.org