Camper Profile Form

Camper Name*

First

Last

Session Attending*

Full Season
1st Session
2nd Session

Camper's Picture

Max. file size: 300 MB.

Please attach a recent digital picture of your camper. Please do not attach group pictures or older pictures.We share these pictures with staff members who will be working with your child to ensure safety.

Health

If your camper is affected by any allergies, please describe:

Does your camper require immediate access to an EpiPen?*

Yes
No

If Yes, please explain:*

Does your camper wear eye glasses or contact lenses*

Yes
No

Does your camper wear any orthodontic gear*

Yes
No

Please describe any physical restrictions that your camper may have while at camp:

Camper Profile/Preferences

Does your camper have any particular fears or sensory issues our staff should be aware of?*

Yes
No

If Yes, please explain:*

Sleep Habits

Our camper is a (please check all that apply):*

Light sleeper wakes up easily from noise
Heavy sleeper will need help waking up
Sleeping Habits Vary (sometimes heavy, sometimes light)
Has trouble falling asleep
Is prone to bed wetting

Our camper will need this level of support with daily hygiene tasks:*

(Please keep in mind that we make sure all campers shower, brush their teeth and hair each day)

Will need reminders
Will need help with some hygiene tasks
Will be fine with completing hygiene tasks independently

What hygiene tasks do you anticipate your camper will need help with?*

How do you anticipate your camper will do with sharing living space:*

Has shared living space before and will be fine with it
May need help learning how to share living space but should adjust
May need a lot of help with learning how to share living space

How does your camper do with keeping their belongings organized, putting away dirty laundry, etc.:*

Is typically neat and tidy
Will need some assistance with these tasks
Will need a lot of assistance with these tasks

Religious Services

We would like our camper to participate in religious services at camp

Jewish
Catholic
Protestant
N/A

Food & Diet

Our camper has food sensitivities that include (please check all that apply):*

Picky eater
Vegetarian
Lactose intolerant
Tendency to overeat
Will eat salad and/or vegetables if encouraged
Other

If Other, please describe:*

Activities

Regarding swimming, our camper (please check all that apply):*

Strong swimmer
Average swimmer
Weak swimmer
Is fearful of water
Needs goggles when swimming
Needs earplugs when swimming

Regarding athletics, our camper (please check all that apply):*

Is overly competitive
Has trouble with losing
Has trouble with being flexible around game rules/wants others to play by his rules
I generally okay with sports
Will need encouragement to get involved in athletic activities
Is a rule follower and gets frustrated when others try to bend the rules or play by rules he has never played with before
Is not athletic and generally would rather sit on the sidelines rather than participate

Please describe your camper's interests:*

Social/Emotional

In regards to getting along with same-age peers would you describe your camper as (please check all that apply):*

Has a tendency to isolate himself
Often believes he is being bullied/singled out
Is anxious being around same-age peers
Likes to be with peers but has difficulty knowing how to initiate socially/sustain friendships
Our camper has a tendency to be overly emotionally reactive and/or negative to certain situations

If emotionally reactive, please describe:*

How would you describe your camper’s level of flexibility with same-age peers (willing to “go with the flow”, compromise, etc.)*

Easy going
Occasional difficulty with being flexible
Consistent difficulty being flexible

Is there any other information you would like our staff to know about your camper?*

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