Previous PageHOMESICKNESS
If your child becomes homesick, what do you recommend for us to do? ___________________
__________________________________________________________________________
How many times will you allow your child to call home? ________________________________
SWIMMING
What is your child's skill level in swimming? _________________________________________
Are there any special instructions for your child to follow during swim time or water
activities?___________________________________________________________________
__________________________________________________________________________
GENERAL INFORMATION
Date of last Tetanus Booster? ___________________________________________________
Does your child have any special fears (storms, animals, loud noises)?
_____________________
__________________________________________________________________________
Has there been anything happen in your child's life that will affect him/her emotionally,
such as moving, illness in family, death of family member or pet, or divorce?
_________________
__________________________________________________________________________
For the safety and maximum benefit of the Camper, does he/she have any behavior
problems that require close supervision? Yes___ No ___ If yes, please explain
______________
__________________________________________________________________________
__________________________________________________________________________
Does your Child require a special diet? ____________________________________________
__________________________________________________________________________
PLEASE SUPPLY US COMPLETELY WITH THE FOLLOWING INFORMATION
Family Physician _____________________________________________________________
Family Dentist _______________________________________________________________
Insurance Plan and Number _____________________________________________________
My child may be given Advil or Tylenol if necessary. Yes
No