Trailways Camper Registration 2025-26
Please complete this form to Register your camper at Trailways Camp.
Please enter Your Email Address.  You will receive an email with the information you submitted after you complete and submit the registration. 
Sign in to Google to save your progress. Learn more
Email *
1. Your Name *
Please enter YOUR First and Last Name below
HAS THE CAMPER ATTENDED A PRIOR TRAILWAYS CAMP?
2. Attended a Prior Camp *
If the camper being registered has attended a Trailways Camp please check RETURNEE below otherwise check NO below
SELECT CAMP DATES
3. Camp Dates *
Select the camps you wish to attend. YOU MUST CHECK AT LEAST ONE CAMP DATE.
Required
CAMPER INFORMATION
Please enter the following information for the camper.
4. Camper First Name *
Please enter the camper's first name
5. Camper Last Name *
Please enter the camper's last name
6. Camper Phone *
Please enter the camper's personal phone number.  If the camper does not have a phone, enter NONE.  Enter the Area Code, Exchange, and Number separated by spaces. For Example: 239 123 1355
7 Camper Email *
Please enter the Camper's email address.  If the camper does not have an email, enter NONE.
8. Primary Contact *
Please enter the Camper's primary contact person's name.
9. Primary Contact Phone *
Please enter the Camper's primary contact person's phone.   Enter the Area Code, Exchange, and Number separated by spaces. For Example: 239 123 1355
10. Primary Contact Email *
Please enter Camper's primary contact person's email.
11. Date of Birth *
Please enter Camper's date of birth.  For example: 11/15/2000
MM
/
DD
/
YYYY
12. Year Last Attended Camp
Enter the Year only of the date the Camper last attended Trailways camp.
If the camper has not attended camp before, please leave blank.
13. Gender *
Please enter the Camper's Gender.  Mark only one.
13a. Ethnicity *
Please choose from ONE of the following.
14. Name Preferred on Badge *
15, T-Shirt Size *
Select one of the following sizes for the Camper T-Shirt Size.  Check only one.
16. Street Address *
17. City *
18. State *
Please use two character abbrevation, such as FL.
19. Zip *
Enter only 5 digit zip code.
20. County *
Please enter the COUNTY the Camper resides in.  For example, Cape Coral is in LEE county. 
21. Camper's Living Situation *
Mark only one.
22. Primary Diagnosis *
Please briefly describe the camper's primary diagnosis
23. Secondary Diagnosis
Please briefly describe the camper's secondary diagnosis
24. Camper Communications *
How does the camper best communicate?  (Check all that apply)
Required
25. Sleepaway Camp *
Has the Camper ever attended a sleepaway camp?
Mark only one.
26. Spend Night Away *
Has the Camper ever spent a night away from their primay caregiver?
Mark only one.
CAMPER EATING HABITS
27. Buffet Style Meals *
Can/does Camper select appropriate food and portions from buffet style meals?
Mark only one.
28. Feed Themselves *
Can/does Camper feed himself/herself without assistance?
CAMPER PERSONAL HYGIENE
29. Personal Toileting *
Can/does Camper take care of all personal toileting needs independently?
30. Shower Independently *
Can/does Camper shower independently?
31. Dental Hygiene *
Can/does Camper take care of dental hygiene independently?
32. Change Clothes *
Can/does Camper change clothes independently?
33. Display Sexual Behavior *
Can/does Camper display sexual behavior?
34. Swallow Oral Medication *
Can/does Camper swallow medication independently? (Dispensed by a nurse -- select NO if they do not have prescriptions)
CAMPER OTHER INFORMATION
35. Support Weight *
Can/does Camper support his/her body weight using their legs?
26. Swim *
Can/does Camper swim?
37. Walker *
Can/does Camper utilize a walker?
38. Wheelchair *
Can/does Camper utilize a wheelchair?
39. Wheelchair Transfer *
Can/does Camper use arms to assist in transferring from wheelchair?
Select NO if camper does not use a wheelchair)
40. C-Pap Machine *
Can/does Camper use a device such as a C-Pap machine?
41. Snore *
Does Camper snore?
42. Staff Assist Camper *
Use this space to explain how camp staff can assist your Camper with any of the above tasks (Hoyer Lift, Feeding Tube, etc.)
If none, please enter NONE.
CAMPER PROFILE
Please be thorough with your answers.
43. Behavioral Issues *
Please describe any behavioral issues this camper currently has, or has had in the past, that the staff/volunteers should know about in advance.  Consider mood swings, sensitivities, phobias, violent outbursts, or any other inappropriate behaviors that the staff and volunteers need to know about to make sure the camper has a safe, fun time at camp.  If none, please enter NONE.
44. Camper Profile *
The more information you can give us about your camper, the better prepared we will be to meet their needs.  Write here as much about your camper as you can: What are they like? What bothers them? What gets them excited? What should staff/volunteers look out for? What can we do to make sure your camper has a safe and fun-filled experience at Trailways Camp? What movies, music, TV shows, sports teams, games, activities, etc. does your camper enjoy?
EMERGENCY CONTACT INFORMATION
Please enter the following Emergency Contact Information.  Enter Primary and, if available, enter Seconday Contact information as well.  PLEASE NOTE, GUARDIAN INFORMATION IS REQUESTED IN A LATER SECTION.
45. Primary Contact Person *
Please enter the Name of the primary contact person.
46. Relation *
Select the item that describes the relation of the Primary Contact Person to the Camper.
47. Phone *
Enter Primary Contact person's Area Code, Exchange, and Number.  For example: 123 123 1234
48. Email *
Enter Primary Contact person's email.  If none, enter NONE.
49. Secondary Contact Person
Enter the name of the secondary contact person along with the following information. This information is optional.
50. Relation
Select the item that describes the relation of the Secondary Contact person to the camper.
Clear selection
51. Phone
Enter Secondary Contact Person Area Code, Exchange, and Number. For example: 123 123 1234
52. Email
Enter the Secondary Contact person email.
53. Court Appointed Guardian *
Does the Camper have a Court Appointed Guardian
GUARDIAN INFORMATION
Please provide the following Court Appointed Guardian information
54. Multiple Guardians *
Does the Camper have Court Appointed Guardians?
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms