Special Needs Form
Greetings from Cedar Lodge. Our goal at camp is to give your camper the best chance experience as possible during their stay with us. Please answer the questions below to the best of your ability.
Campers name: *
Your answer
Parent's name: *
Your answer
Parent's email *
Your answer
Does your child have any special health or behavioral considerations which might affect them during their stay at Cedar lodge? If yes, please state below and elaborate. For example ADHD, bedwetting, if your child is a vegetarian etc... *
Your answer
Cell Phones: I understand that cell phones are not allowed at Cedar Lodge. My camper will not have a cell phone or internet device with them during their stay at Cedar Lodge. Please type your name and date below to acknowledge this policy. *
Your answer
Permission to leave camp: I hereby give permission for my child to leave Camp Cedar Lodge on visitors day with other camper's parents if I am not able to visit. Please put the name of camper's below your child is allowed to leave camp with.
Your answer
In addition, I give permission for the adult listed below to pick up my child, listed above for a visitor's day visit, and/or to bring the camper back to our home at the end of the camping period. Please put adults allowed to transport your child other than his parents below.
Your answer
Medical Insurance Information Policy group/Company: *
Your answer
Medical Insurance Policy number: *
Your answer
Medical Insurance full address: *
Your answer
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