About the Personal Information Form... NEW camp families The following form is read by me, as well as those supervisory staff and counselors who work most directly with your camper. As you complete this form, you are speaking directly to the staff who will be with your camper every day. The information you share helps them create a happy and safe experience for your child. In addition, the nurses at our Camp Health Center read the Health Information Profile that you are providing. They share information from this with other staff on an as needed basis. Thank you very much for taking the time to fill this out. Let me know if you have any questions or would like to chat about your camper. Tom Riddleberger Director RETURNING camp families The Personal Information Form is read by me as well as those supervisory staff and counselors who work most directly with your camper. Some of this summer s staff DO NOT YET KNOW YOUR CHILD. Therefore, even though you have completed a form like this in the past, we ask that you complete a new one now, remembering particularly those staff who are meeting your camper for the first time. Even for our returning staff, however, learning about new events, accomplishments, joys and concerns is very helpful as we strive to provide the best possible camp experience for your daughter or son. It has been a whole year! In addition, our camp nurses read the Health Information Profile that you are providing. They share information from this with other staff on an as needed basis. Thank you very much for completing this for the new camp season. Let me know if you have questions or would like to chat about your camper. Tom Riddleberger Director Please see the following pages for the 2019 PERSONAL INFORMATION FORM Campus Kids Summer Camp
2019 PERSONAL INFORMATION FORM Campus Kids Summer Camp DUE MAY 15 earlier if possible TO BE COMPLETED BY A PARENT/GUARDIAN (not by the camper). One form required for each camper -- whether a first-time or returning camper. Feel free to use additional paper. Thank you for sending this back as soon as possible. RETURN TO: Tom Riddleberger, Director Campus Kids P.O. Box 8 Madison, NJ 07940 ; fax: 973-845-9262 After June 4: Tom Riddleberger, Director Campus Kids P.O. Box 369 Blairstown, NJ 07825 973-845-9262 (fax) The purpose of this form is to help our staff meet the individual needs of your camper. Parent input is important as we help your child to make a smooth and happy adjustment to camp and to get the most from this special experience. This information is used with professional discretion by the the camp director and those staff who work with your child. Our commitment is never to misuse this information or release it to unauthorized persons. We care about each child and want to do what is best for them. Having knowledge about such things as accomplishments, significant events during the past year, learning difficulties, school situations, socialization issues, goals, or changes in the family s or the child's life -- can help us support your child. This information is also important for returning campers. Even for the returning campers we know well, we would like to know the important events and current challenges in their life. If you have any special concerns about this information or about your child, please feel free to call. As a team, we will help your child have an amazing camp experience. Thank you! Camper s First Name: Last Name: Nickname (if used): Date of Birth: Grade NEXT Sept.: Current School Attending: Current Town of Residence: 1. Camper s Residence Who lives in this household? Adults (names & relationship to camper): Other Children (names, relationship & ages): 2. Camper s Other Residence (if applicable) Who lives in this household? Adults (names & relationship to camper): Other Children (names, relationship & ages):
-2-3. Are there other people (adults or children) whom your child is close to and is likely to miss while at camp?_ 4. Are parents separated or divorced? If so, how is child's time divided with each? 5. Is either parent away for long periods of time? 6. Is there any serious illness in the family? 7. Has there been a recent death in the family? If so, who, and how has your child reacted? 8. Does your child wet the bed? If so, how often, how is this handled at home, and what suggestions do you have for camp? 9. Is this your child's first overnight camping experience? If so, do you have any specific concerns? 10. What specific suggestions do you have to make your child's experience at Campus Kids a good one? 11. What expectations do you have for your child's stay with us? 12. Does your child have a bunk group request? If so, who? Have you checked to see if this is a "mutual request"? You may have already provided this information on the enrollment form. If there have been any changes, let us know. We honor mutual bunk group requests. We always try to honor roommate requests, but cannot guarantee these.
-3-13. Please describe any food allergies your child has: 14. Please describe any other dietary restrictions or special instructions regarding food: 15. Describe any non-food allergies your child has: 16. Does your child have orthodontia? Are there specific procedures to be followed other than brushing teeth? 17. Does your child wear glasses? Contact lenses? Any special procedures to be followed? 18. Briefly describe your child's personality: 19. Describe any special fears your child has (e.g., darkness, animals, competition, etc.): 20. Does your child have any learning challenges that we should be aware of? 21. Does your child have any other needs (e.g., physical, emotional, social, intellectual) that we should be aware of?
-4-22. Your camper receives a "Camper Choice Survey" from us in the Spring, giving them the chance to tell us what they want to do at camp. Are there activities that you particularly hope your camper will try? 23. Does your child have goals for skill development in any of our camp program activities? 24. What are the talents your child is proudest of? Drama Dance Singing Instrument ( ) Arts Sports Computers Nature Other: Comments: 25. Your child's swimming ability: Non-swimmer Beginner Intermediate Advanced Do you have any particular suggestions/concerns regarding your child's swimming experience at camp? 26. Campers have the opportunity to call home once each day. What have you discussed with your camper regarding phone calls home? once a day once or twice a week other: pre-paid calling card camper s cell phone camper s pre-paid mobile phone NOTE: It is expected that a camper will not call home more than once a day unless parents are in different locations. There are strict rules regarding cell phone use. The Parent Handbook has all the details about phone calls and cell phones. NOTE: Campers calling home will do so right after dinner and before Clubs, i.e. between 6:40 and 7:00 PM. 27. Is there other information that you would like to share with us? (You may attach additional paper, give us a call, or send email to.) 28. Name of person completing this form: Date: Thank you!