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 *
Camper Last Name *
Camper Age *
Camper Date of Birth *
Camper Gender *
Camper Race/Ethnicity
Week of Camp *
Camper Address Line 1 *
Camper Address Line 2
Camper City *
Camper State *
Camper Zip *
Camper School
Parent or Guardian Name *
Parent or Guardian Employer
Parent or Guardian Phone Number *
Parent or Guardian Email *
Emergency Contact 1 Name *
Emergency Contact 1 Phone Number *
Emergency Contact 2 Name *
Emergency Contact 2 Phone Number *
How did you hear about our camp program?
Clear selection
Does the camper currently receive services at NCTRC? *
Please provide a brief explanation of the camper's experience with horses (if any).
Please provide a brief explanation of the camper's special needs and any equipment used.
Please list any dietary restrictions or allergies that we should be aware of.
Please list any medications that the camper may need to take during camp.
Please list any friends or family that are also attending camp.
Please let us know if there is any additional information that would help us make this a fabulous camp experience.
A copy of your responses will be emailed to the address you provided.
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