Please fill out this form for each registered camper.

Complete this form for each registered camper by June 1

Questions or concerns? Let us know at joni@summerquests.com
You can save this form and complete it later. An email will be sent to you with a link to access your form.

A copy of this form will be emailed to you after you submit.

If you need to make edits to this form after completion, please use the Edit Form link found on the bottom of the confirmation email. Thanks!
Camper Name*

First NameLast Name
Camper Birthdate*

MonthDayYear
Date
The adult listed here will always be contacted first in the event of an emergency and is by default an Authorized Pick Up.
Your Name*

First NameLast Name
Your Email*
A copy of this form will be sent for your records.
Your Phone Number (M-F, 9am - 4pm)*
Alternative Phone Number

Camper Emergency Contacts

In the event of an emergency, the adult listed on the first page will be contacted first, moving on to the below contacts only if that person cannot be reached.

Camper Pick Up - Authorized Adults

If you would like to authorize other adults to pick up your camper besides the adult listed on the first page, please list them here.

Camper Health Information
Camper Health Insurance Card

Browse Files
Optional - Take a picture of the card and upload it here. Make sure the lighting is bright enough! Cancelof
Date of Last Medical Exam*

MonthDayYear
I certify that my campers immunizations are all up to date as required by the CDC and the PA Department of Education.*

I agree
Camper Allergies and/or Restricted Foods*
Please list all medications the camper uses on a daily basis. Include medication name, time of day, and dose. Mark any that will need to be administered while camp is in session with an asterisk (*).*
Please tell us about any mental health, learning differences, or other history that requires accommodation at school or additional explanation. All information will be held in the strictest of confidence and only used to ensure your camper is enjoying our program.*
I hereby give permission for SQDC to give my camper special treats occasionally such as popsicles, lollipops, or other small candy.*

Yes, except any Allergies/Restricted FoodsNo
Is the camper allergic to or afraid of dogs? Occasionally Joni may bring her dog to camp, but only when all campers are ok with it.*

Camper is allergicCamper doesn't mind if a dog is nearbyCamper doesn't really like dogs or is afraid
Camper Well Being Information

This information will help ensure your child will have a successful experience at camp. Knowing a little about who your child is before they even arrive is invaluable information for activity planning and for making your child feel welcome on the first day.
Has the camper attended day camp in the past? If so, where? (let's us know who might need more support early in the session if they are not used to being at a camp)*
Tell us about something your child loves (eg. sports, art, video games, fav movie, etc) (lets us know what we can talk to your child about so we can strike up a conversation easily making them feel more comfortable)*
Is there anything else you would like to tell us about your child, home, or family situation? (this lets us know what might be worrying your kiddo so we can support them better)*
List a song (or songs) that your camper would like to hear in our playlist:

Camp Communication
FOLLOW US ON SOCIALS
@campsummerquests

Facebook and Instagram
BAND APP
Get easy access to reminders, notifications, and camper pictures! Parents/Guardians and Campers are invited to connect with us (and each other) on the Band App.

Be sure to ALLOW PUSH NOTIFICATIONS for the app on your phone so it can let you know when new information is available. Bookmark the page on your computer and visit it anytime. Camper pictures will be posted daily.

If you joined back last summer, you will need to join again - all members have been removed to ensure only current registered families are part of our group.

Please use your full name or other identifier (eg. your name/camper first name) when you join so I can easily place you into a subgroup for your session. Parents (and campers too!) are welcome to contact each other through this private platform.

Releases
VALUABLES AGREEMENT: I understand that SQDC cannot be responsible for entertainment valuables that are lost or broken at camp. Anything that cannot get lost, dirty or broken should remain at home. This includes toys, cell phones, mp3 players, headphones, video games, smart watches, etc.*

Yes
FIRST AID RELEASE: I hereby give SQDC my consent to administer basic first aid as per First Aid Training including, but not limited to: ice packs, bandages, wound cleaning, antibacterial ointment, and topical anti-itch.*

Yes
SUNSCREEN APPLICATION: Campers will be asked to apply sunscreen at least twice per day, with an additional application if they choose to participate in water play. Staff will assist campers with this application, if needed, unless you check below to not allow this. Staff will only assist campers who ask for help or when asked, verbally give permission.*

Yes, SQDC Staff can assist with camper sunscreen application with permissionNo, SQDC Staff cannot apply sunscreen to my child
Photo Release: I hereby grant permission to SQDC to use photographs and/or video of my camper - without identifying information - in publications and in other communications related to the mission of SQDC.*

Yes
SQDC Policies & Procedures
Please sign with your finger or mouse: I have read and agree to abide by SQDC Policies and Procedures, including the releases. I certify that the information on this form is correct to the best of my ability. I will notify SQDC Staff of any changes to the information submitted on this form.*

Clear
Should be Empty:

Complete this form for each registered camper by June 1

Camper Emergency Contacts

Camper Pick Up - Authorized Adults

Camper Health Information

Camper Well Being Information

Camp Communication

Releases

SQDC Policies & Procedures