David's Refuge Application

If you have stayed in 2019 or have a stay scheduled for 2019 please DO NOT fill out an applications for 2020. We will be making major renovations to our process. This does not apply to new applicants ONLY those that have stayed in 2019 or have a stay already scheduled. 

David’s Refuge is for parents or guardians who care full-time at home for children with special needs or life-threatening medical conditions.

This application is the first step in the reservation process. Current OPWDD eligibility (or equivalent documentation if you do not live in New York State) or medical documentation of a life-threatening disease is required and provides a baseline for determining your eligibility. We will also request a copy of your child’s current IEP (504 or IFSP if applicable.) If your child receives full time care at home but is not OPWDD eligible because their disability began after the age of 22 or if you have any other questions, feel free to contact us at 315-682-4204. If you have not visited our FAQ page, please do so by clicking here: FAQ’s

Please fill out the application below as thoroughly as possible to help us determine your eligibility. Once determined and space is available, we will be in touch to schedule your stay. If an approved parent is not married, the only guest that would qualify to attend with them is a partner who resided in the same home as the primary applicant and is significantly involved in the care of the child with special needs or life threatening illness.

 






















If applicable, please describe the level of care you provide for your child in each the following areas (the more detail you provide, the easier it will be to process your application)



















If you are not sent to the thank you page after submitting this form please check that all the required fields are filled in.

Do you have questions or need more information?
Call us at 315.682.4204 or email at : www.davidsrefuge.org/contact