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CAMPER QUESTIONNAIRE Must be filled out, signed & returned for the camper to participate in camp activities. This form will be read by the camp directors as well as your child’s counselor.
Camper Name______________________________________________________________ Tell us about your child’s family life? (parents, marital status, siblings, etc.)_____________ ______ ________________________________________________________________________ What are your child’s hobbies and interests?______________________________________ ________________________________________________________________________ ______ What is your child most looking forward to at camp?________________________________ ________________________________________________________________________ ______ How is your child feeling about going to camp?_____________________________________ ______ How does your child usually socialize with others? (circle one) Makes friends easily Takes time to warm up Has difficulty making friends
Does your child ever have problems at night? (bedwetting, sleepwalking, night terrors, etc) ________________________________________________________________________ ________________________________________________________________________ ______ Does your child have any fears? Please list._______________________________________ ______ ________________________________________________________________________ Are there any medical conditions that we should know about?_________________________ ______ ________________________________________________________________________ ________________________________________________________________________ Any emotional or behavioral problems that we should know about?_____________________ ______ ________________________________________________________________________ ________________________________________________________________________ What else would you like to tell us about your child?________________________________ ______ ________________________________________________________________________ ________________________________________________________________________
I have read and understand all of the information and policies contained in the May Packet. Parent/Guardian Signature______________________________ Date__________________
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