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Clayton’s House Referral Form
Clayton’s House Referral Form for Application for Stay For completion by a clinical team member from the patients treating HealthCare Provider The Dempsey Center offers programming in Lewiston & South...Clayton’s House Guest Application
Clayton’s House Guest Application and Waiver Form For completion by Guest Submission of this completed Form is a pre-requisite to a Guest’s stay at Clayton’s House. Identification of Guest Name:(Required)...Clayton’s House Care Partner Application
Clayton’s House Care Partner Application and Waiver Form For completion by Care Partner Submission of this completed Form is a pre-requisite to a Guest’s and Care Partner’s stay at Clayton’s...Living Well with Cancer
Living Well with Cancer Series...Movement and Fitness Classes
Establish your fitness goals and learn how movement can benefit you before, during, and after a cancer diagnosis and treatment.Nutrition Classes
Establish your fitness goals and learn how movement can benefit you before, during, and after a cancer diagnosis and treatment.Living Beyond Breast Cancer
Living Beyond Breast Cancer Series Living Beyond Breast Cancer is a national nonprofit providing information and support to patients newly diagnosed, in treatment, post-treatment, and those living with breast cancer....Community Garden Volunteer (Non-Client Facing Position)
Position Title: Community Gardener Volunteer Reports to: Nutrition Program Coordinator Position Location: Dempsey Center Community Garden (Auburn/Lewiston Area) Schedule and Hours: Seasonal, 1 ½ – 3 hours per week...Space to Breathe Camper Info
Space to Breathe Camper Info Camper Name:(Required) First Last Camper Date of Birth:(Required) MM slash DD slash YYYY Emergency Contact #1:(Required) First Last Email(Required) Relationship to Camper:(Required) Phone:(Required) Emergency Contact...Space 2 Breathe
Space 2 Breathe 2024 An adventure-based therapeutic camp for teens ages 12-17 impacted by a parent or sibling’s cancer. A 4-Day, 3-Night Camp for Teens Impacted by Cancer. Space to...Amanda Dempsey Award
The Amanda Dempsey Award is given away annually to a survivor in Maine who inspires and supports others with a cancer diagnosis.Amanda Dempsey Award Nomination Form
General Volunteer Application
Dempsey Center Volunteer Application "*" indicates required fields Thank you for your interest in becoming a Dempsey Center Volunteer. There are a number of volunteer opportunities requiring varying lengths of...Clayton’s House Care Partner Exemption Form
Clayton’s House Care Partner Exemption Form To be completed by a referring provider for a client who wishes to stay at Clayton’s House without a Care Partner. I understand that...Space to Breathe Parent Waiver
Space to Breathe Parental Waiver and Release PARENTAL WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT FOR MINOR PARTICIPANT PLEASE READ CAREFULLY, THIS IS A LEGAL DOCUMENT...Connection with Humanity | Patrick Dempsey at Clinton Global Initiative 2023
