Camp AmeriKids- Full Application Checklist

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Full Application Checklist

Due Dates

Due by Friday, April 6^th	Due by Friday, May 4^th
Camper Application • The Returning Camper Application is for children who attended camp in 2011. All other children must fill out a New Camper Application. Information Release Form • To be read and signed by parent/guardian Camper’s Psychosocial History • Please have this form filled out by the child’s social worker, case manager or therapist. If unavailable, form may be filled out by parent/guardian. HIPAA Form • To be completed by parent/guardian Copy of Individual Education Plan (IEP) if in Special Ed Copy of Recent Report Card (if possible) • Acceptance to camp is not based on grades. Report cards help us to better understand your child and meet their needs at camp.	Medical Paperwork Camper Medical Application • To be filled out by the camper’s physician Copy of Camper Immunization Record • Note: Returning campers do not need to submit this unless there are updates • Attach a copy of current immunization record; a camper may be prevented from attending AmeriKids if we do not receive this information. Copy of the Camper Insurance Card • All children attending camp are required to submit a copy of their current insurance card for prescription refills and for use in the event of an emergency. • Even if this card has been submitted before please do so again. Individual Orders Form • To be filled out and signed by camper’s physician Meningitis Vaccination Form • To be completed by parent/guardian • Your child is not required to receive this vaccination; we just need to know if he/she has received it or not.

Due by Friday, April 6^th

Due by Friday, May 4^th

Camper Application
• The Returning Camper Application is for children who attended camp in 2011. All other children must fill out a New Camper Application.
Information Release Form
• To be read and signed by parent/guardian
Camper’s Psychosocial History
• Please have this form filled out by the child’s social worker, case manager or therapist. If unavailable, form may be filled out by parent/guardian.
HIPAA Form
• To be completed by parent/guardian
Copy of Individual Education Plan (IEP) if in Special Ed
Copy of Recent Report Card (if possible)
• Acceptance to camp is not based on grades. Report cards help us to better understand your child and meet their needs at camp.

Medical Paperwork

Camper Medical Application
• To be filled out by the camper’s physician
Copy of Camper Immunization Record
• Note: Returning campers do not need to submit this unless there are updates

• Attach a copy of current immunization record; a camper may be prevented from attending AmeriKids if we do not receive this information.
Copy of the Camper Insurance Card
• All children attending camp are required to submit a copy of their current insurance card for prescription refills and for use in the event of an emergency.

• Even if this card has been submitted before please do so again.
Individual Orders Form
• To be filled out and signed by camper’s physician
Meningitis Vaccination Form
• To be completed by parent/guardian

• Your child is not required to receive this vaccination; we just need to know if he/she has received it or not.

Remember: The earlier applications are sent in, the better!

If you have any questions or need any assistance with completing these forms, just give us a call at 203-658-9547.