Health and Care Information 💉 Last Tetanus Shot Personalize Your Child’s Experience Help us get to know your child! Tell us anything you think would be helpful — their diagnosis, interests, personality, friendships, routines, things they love (or don’t), what helps them feel calm, and anything that might make their day go smoother.
Medical conditions and concerns Please list any medical conditions or concerns we should be aware of.
Seizure history Does the participant have a history of Seizures? If yes, please give details.
Medications Please list all medications the participant takes, including both prescription and over-the-counter — even if they aren’t needed during camp hours. This helps us provide accurate information to first responders in case of an emergency. All medications must: Be submitted to the Program Supervisor at drop-off (except rescue inhalers and EpiPens, which should stay with the participant). Come in their original packaging with the pharmacy label attached.
Allergies Please list all known allergies, including food, environmental, and medication allergies.
Dietary restrictions Please list any dietary restrictions, such as vegetarian, vegan, gluten-free, etc.
Personal care support needs Please outline the participant’s personal care support needs (for example: independent, needs reminders, or requires full assistance). If applicable, does the camper use incontinence products?
Exit seeking behavior Does the participant have a history of exit-seeking behavior? If yes, please give details.
Community navigation support Is the participant able to navigate the community safely? Will they require additional support while walking or traveling in the community? What types of behaviour should we expect in a car? A bus?
Swimming level & floatation needs What is the participants swimming level? Do they require a floatation device? Do they enjoy swimming, or is there anything we need to know about getting them dressed for water?
Additional information Is there anything else you think we should know to help make this the best experience possible?
Payment Information $400 Registration Fee for the full week or $85 per day. Invoices will be sent to the email on this form. 50% of registration costs will be due within 7 days of receiving the registration forms, with the remaining 50% due on the first day of care. *1-1 care will be discussed as needed.
Be certain to enter your email address correctly on the registration form to receive confirmation via email within 7 days.
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency, I give consent for medical treatment for the above named camper by authorized personnel. The camp carries secondary insurance. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activities.
