Camper Individual Care Plan

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Everyone at camp wants your child to have the best camp experience possible. To help in this effort, we ask for parents to fill out this form only if there are special concerns or situations that you feel we need to know. The more detailed information and helpful “tips” you are able to give, the better prepared we are to work with your child.

This information with be kept confidential. Only the camp director, appropriate lead staff & counselor(s) will be able to access the information below.

Email *

Camper Full Name (First & Last) *

Camper Age *

Parent/Guardian Full Name (First & Last) *

Parent/Guardian Phone Number *

What weeks will your child be attending camp? *

Session 1: June 10-14

Session 2: June 17-21

Session 3: June 24-28

Session 4: July 1-3

Session 5: July 8-12

Session 6: July 15-19

Session 7: July 22-26

Session 8: July 29-August 2

Session 9: August 5-9

Session 10: August 12-16

Required

Behavioral Concerns, Triggers & Helpful Tips: *

Medical/Allergy Concerns, Things to Watch for, Actions to take: *

Other Concerns/Situations: Please share with us other concerns or anything else you think would be beneficial to know, when working with your camper. *

A copy of your responses will be emailed to the address you provided.

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