Boundless Adventures Kenosha Summer Camp Form 2026

  • Section I: General Information

  • Birth Date*
     - -
  • Gender*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Which week will your child be attending camp?*

  • Section II: Medical Information

  • Allergies & Diet

  • Allergies*
  • Diet, Nutrition*

  • Medical Insurance Information

  • This camper is covered by family medical/hospital insurance*

  • Medication

  • Medication*

  • The following non-perscription medications may be stocked in camp and are used on an as needed basis to manage illnesses and injury. 

  • Please indicate which medication should NOT be given.

  • General Health History

    Check "Yes" or "No" for each statement. Explain "Yes" answers below. Has/does the camper:
  • Had a recent injury?*
  • Had asthma/wheezing/shortness of breath?*
  • Had seizures?*
  • Had headaches?*
  • Had fainting or dizziness?*
  • Passed out/had chest pains during exercise?*
  • Have any skin problems?*

  • Mental, Emotional, and Social Health

    Has the camper:
  • Ever been treated for attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (AD/HD)?*
  • Ever been treated for emotional or behavioral difficulties or an eating disorder?*
  • During the past 12 months seen a professional to address mental/emotional health concerns?*
  • Had a significant event that continues to affect campers life? (History of abuse, death of a loved one, family change, adoption, foster care, new sibling, survived a disaster, other)*

  • Health-Care Providers

  • Format: (000) 000-0000.

  • Boundless Adventures Code of Conduct

  • Boundless Adventures is dedicated to providing an outstanding program. To accomplish this goal, participants are expected to behave appropriately and promote a safe, fun, and healthy environment through productive participation. We aim to promote character values of caring, honesty, respect, and responsibility in all aspects of our program. We ask that all participants and parents/guardians read this code together before arriving.

    As a participant, I will:

    RESPECT
    -Be respectful, cooperative, and will contribute positively to the experience of fellow participants.
    -Be careful and considerate that my actions will not hurt another participant’s feelings or hurt them physically, either intentionally or accidentally.
    -Show respect to the staff, and cooperate fully with their instructions.
    -Respect the rights and beliefs of others, and treat others with courtesy and consideration.
    -Respect the property of others. This includes personal property, camp property and equipment/supplies.
    -Never mark, deface or destroy Boundless Adventures or personal property or nature.

    BEHAVIOR
    -Conduct myself responsibly. I understand that horseplay, inappropriate touching, unwelcome teasing/bullying, or other unkind behaviors are not allowed and will not be tolerated.
    -Communicate in an appropriate manner, which means I will not use foul language or gestures, harsh words, or raise my voice.
    -Refrain from deliberately causing bodily harm to the participants or staff. I understand that pushing, kicking, hitting or fighting are not acceptable behavior and will not be tolerated and will be grounds for suspension/dismissal from the program.

    SAFETY
    -Participants must wear closed-toe/closed-heel shoes at all times.
    -Participants need to pay attention to their surroundings and use care in all activities.
    -Participants will adhere to all safety rules and regulations given for each activity he/she participates in while at Boundless Adventures.

    GENERAL
    -Participants are expected to wear appropriate clothing to Boundless Adventures each day.
    -Participants must inform the staff if they are experiencing a problem with another participant or other issues. If the staff are not informed about a problem, they cannot stop the problem or assist the participant.
    -We expect all participants to have FUN, but not at the expense of others.
    -We expect all participants to follow their guardians rules with regard to social distancing requirements.
    -Participants are encouraged to participate in all activities to the best of their ability.
    -Violation of the Code of Conduct can be grounds for automatic dismissal. Refunds are not given when a participant is dismissed from a program.
    -Weapons, look-alike weapons, or objects that may be used to threaten, intimidate, or harm others or to damage property may not be brought to Boundless Adventures.

  • Should be Empty: