Camper Questionnaire 2020
Please complete one form for each camper, at least 30 days prior to the start of their camp week. This ensures that we are prepared to provide the best possible experience for every camper! We look forward to seeing you this summer!
Email address *
Camper First Name *
Your answer
Camper Last Name *
Your answer
Camper Age *
Your answer
Camper Date of Birth *
MM
/
DD
/
YYYY
Camper Gender *
Your answer
Camper Race/Ethnicity
Your answer
Week of Camp *
Required
Camper Address Line 1 *
Your answer
Camper Address Line 2
Your answer
Camper City *
Your answer
Camper State *
Your answer
Camper Zip *
Your answer
Camper School
Your answer
Parent or Guardian Name *
Your answer
Parent or Guardian Employer
Your answer
Parent or Guardian Phone Number *
Your answer
Parent or Guardian Email *
Your answer
Emergency Contact 1 Name *
Your answer
Emergency Contact 1 Phone Number *
Your answer
Emergency Contact 2 Name *
Your answer
Emergency Contact 2 Phone Number *
Your answer
How did you hear about our camp program?
Does the camper currently receive services at NCTRC? *
Please provide a brief explanation of the camper's experience with horses (if any).
Your answer
Please provide a brief explanation of the camper's special needs and any equipment used.
Your answer
Please list any dietary restrictions or allergies that we should be aware of.
Your answer
Please list any medications that the camper may need to take during camp.
Your answer
Please list any friends or family that are also attending camp.
Your answer
Please let us know if there is any additional information that would help us make this a fabulous camp experience.
Your answer
A copy of your responses will be emailed to the address you provided.
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