• Gardendale, AL Royal Family KIDS Camp - Camper Application 2021

    Gardendale, AL Royal Family KIDS Camp - Camper Application 2021

    July 12th to 16th, 2021

  • Thank you for applying for your child to attend our summer camp, sponsored by Gardendale-Mt. Vernon UMC in Gardendale, Alabama. This camp is open to children with current or past history of neglect and abuse leading to foster care placement.  We are very blessed to be able to serve these children each summer!  The camp is a sleepover camp, and there is no charge.  Please complete this application form thoroughly, as we do not have unlimited slots for campers. Also, please note that there are two signature pages and a horse program participation form that must be printed and signed.  Completing this online form does not complete the entire application.

  • CAMPER'S GENERAL INFORMATION

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  •  - -Pick a Date

  • Note: Campers must be age 6-11 at camp time, July 12th to 16th, 2021.

  • Please Note: Trained professionals assist the children with horseback riding at camp. The Horse Program Participation Form included with the signature pages must be printed, signed, and returned in order for the camper to ride.  Horseback riding is not required if a child prefers not to participate.

  • CAREGIVER INFORMATION

  • SOCIAL WORKER INFORMATION

  • Please click "Next" to go to the next part of the application.

  • CAMPER'S EMOTIONAL AND BEHAVIORAL HISTORY

  • Please select the most appropriate response for each item. This helps us get to know your camper in advance of the camp and helps us with assignment of camp counselors and bunking arrangements.

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  • CAMPER'S HEALTH HISTORY

  • Please answer the questions in this section as thoroughly as possible. Indicate known allergies, illnesses, disabilities, physical limitations, or medical complications.

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  • PLEASE NOTE THAT AN UPDATED COPY OF THE CAMPER'S IMMUNIZATION RECORDS (BLUE FORM) MUST BE SUBMITTED IN ADVANCE OF CAMP.

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  • PRESCRIPTION MEDICATIONS

  • Please complete the following information for any prescription medication the camper will need to take at camp. All medication sent to camp must be in the original container with the pharmacy label on it.

  • Please click "Next" to go to the next part of the application.

  • INSTRUCTIONS FOR APPLICATION COMPLETION

    Please read the following instructions carefully, as additional printed documents must be submitted to complete the application and ensure a placement in camp or on a waiting list. Please remember to hit the submit button to complete the online portion of the application after you have downloaded the additional documents.
     
     
    Submitting an application does not guarantee a camp position for your child.  Our slots are limited by the number of volunteers who serve so that we can provide the safest environment for your child.  Please note that camp positions will be prioritized as follows, as long as fully completed applications (including signature pages and the immunization record) are returned before placements begin around June 1st.  After placements begin, we will award slots on a first come/first serve basis.
    • Returning campers have first priority.
    • New campers who are still in the foster care system have second priority. We always have positions for new campers still in foster care.
    • New campers who have a prior history of being in the foster care system, but who have returned to their biological families or have been legally adopted have third priority.

    We will notify you of your child's acceptance into camp as soon as we can do so. Please note that placements may not be confirmed until sometime in June when we know how many volunteers will be working at the camp. 

    Medical Information and Permission Forms Requiring Signatures on Paper

    These additional pages must be printed, signed, and returned to complete the application. One requires a physician's signature. There is also a permission form for our horse program.  Please download these items here, print, and complete them as soon as possible.
     
     
    Note: if you are a social worker or foster parent and your DHR office will not allow you to sign the horse program permission form as written, please contact David Ansardi at dansardi@gmail.com or 205-913-2594 for more information.
     
     
    These signed, completed pages and an updated immunization record must be submitted to complete your camper's application.  
     
     
    Return these items to:
     
     
    David C. Ansardi
    Child Placement Coordinator
    Gardendale – Mt. Vernon United Methodist Church
    805 Crest Drive Gardendale, AL 35071
    dansardi@gmail.com (scan and send as an attachment)
    Phone: 205-913-2594
     
     
     
    A COPY OF THE CHILD'S IMMUNIZATION RECORDS (BLUE FORM) MUST BE SUBMITTED IN ADVANCE OF CAMP. 
     
     
    PLEASE DON'T FORGET TO HIT THE SUBMIT BUTTON BELOW.  IF THE FORM WILL NOT SUBMIT, YOU DID NOT COMPLETE ONE OF THE REQUIRED ITEMS ON THE FORM.  SCROLL BACK UP TO COMPLETE IT.
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