Camper Questionnaire

Camper Questionnaire

Please complete the form below.

Required Fields *



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Emergency Contacts

Please provide 2 emergency contacts for the camper.

**Both emergency contacts MUST be available to pick up the camper at any time throughout the week in case of early dismissal, for any reason as determined by Directors and/or Manager.

 

A copy of the camper’s MAR (medication administration record) MUST be provided to camp at time of camper drop off or before. You can request this directly from your pharmacy.


Medical Information

Please complete the fields below. If this is the Camper’s first year at camp, a medical form completed by a doctor may be requested by the Camp Manager.


Daily Living Skills

Regarding the registered camper, what level of assistance is required for the following tasks...


Communication

Please note that any communication aids need to be sent with the camper.


Mobility

Please note that any aids must be sent with the camper.


Toileting

If the camper utilizes incontinence products, please send with the camper.


Dietary

Please note that depending on the dietary requirements, the camper may be requested to bring their own food or supplements.


Behavioral

Please note that if a behavioral support plan (a document that describes behavior of concern along with signs of anxiety and how to address the concerning behaviors) is in place for the camper, a copy MUST be provided to camp.


General Information