Camp Dates: July 28th to August 1st, 2025
Priority will be given to camper's from Taylor County.
Camper Information
Person Filling Out Application
First Name
Last Name
Your Email
example@example.com
Child's Legal Name
*
First Name
Last Name
Name to be called at Camp
Gender
*
Male
Female
Camper's Birthday
*
-
Month
-
Day
Year
Date
Camper's Age
*
Camper's Race
*
Please Select
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Prefer Not To Say
What city/town is the camper from?
*
*not where they are currently placed
What county is the camper from?
*
Please Select
Taylor
Jones
Callahan
Nolan
Fisher
Shackelford
Coleman
Runnels
Other
*not where they are currently placed
If other, please specify
What city/town does the camper currently reside in?
*
What county does the camper currently reside in?
*
Please Select
Taylor
Jones
Callahan
Nolan
Fisher
Shackelford
Coleman
Runnels
Other
If other, please specify
Camper's Status with the Foster System
*
Please Select
Currently in Foster/Kinship Care
Previously was in Foster/Kinship Care
At risk of being placed in the Foster System
No association with the Foster System
Level of Care Needed
*
Basic
Moderate
Specialized
If moderate or specialized, please explain. Note, our volunteers are not trained to provide for specialized medical care/needs.
Swimming Ability
*
Good
Poor
Do Not Know
Do they have permission to swim?
*
Yes
No
Camper Tshirt Size
*
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Adult X Large
Camper Shoe Size
*
Camper Pant Size
*
Has the child ever attended a Royal Family KIDS Camp?
*
Yes
No
If yes, when and where?
Child is currently living with:
*
Foster Home
Group Home
Relative/Kinship Placement
Birth Parent
Adoptive Parent
How long has the child been in your care? How long in foster care?
*
Has the child moved often? (multiple placements)
*
Yes
No
Is the child currently separated from siblings?
*
Yes
No
No Siblings
Back
Next
Guardian Information
Please provide the following information about child's current guardian/parent.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Back
Next
Agency Details
Foster Agency
*
Contact at Agency
*
Agency Phone Number
*
Please enter a valid phone number.
DFPS Worker's Name
*
DFPS Worker's Phone Number
*
Please enter a valid phone number.
DFPS Worker's Email
*
example@example.com
Emergency Contact
Name of Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Person authorized to pick up child.
*
First Name
Last Name
Person authorized to pick up child. (If more than one person)
First Name
Last Name
Person authorized to pick up child. (If more than one person)
First Name
Last Name
Back
Next
Camper's Emotional/Behavioral History
Evaluate the following traits
*
Often
Sometimes
Not at All
Aggressiveness
Anger
Bedwetting
Biting
Eating Disorder
Firestarter
Hyperactivity
Lying
Night Terrors
Nightmares
Running Away
Sexually Acting Out
Stealing
Tantrums
Withdrawn
Please give details regarding the above traits if marked "often" or "sometimes"
*
Describe why this child was placed in Foster Care and any unusual family circumstances this child has experienced in the past (severe social or economic deprivation, physical abuse, sexual abuse, neglect, abandonment, recent crisis, adopted, etc) that have had an impact on this child.
*
Which words best describe the child? (bored, forceful, interrupting, cheerful, leader, loner, shy, impatient, sympathetic, enthusiastic, kind, high energy, gentle, moody, aggressive, sneaky, etc)
*
What are a few of the most important things we should know about this child?
*
What helps this child feel comfortable (things he/she likes to do)?
*
What triggers negative behavior, and what are the signs that it is about to escalate?
*
What type of positive discipline is effective, and what helps to de-escalate behavior?
*
Back
Next
Camper's Health History
Indicate all known allergies, illness, disabilities, physical limitations, or medical complications
Food Allergies
*
Medication Allergies
*
Diagnosed Illnesses/Disorders/Medical Complications
*
Disabilities/Limitations
*
Any specific activities to be restricted?
Immunization History
*
Browse Files
Drag and drop files here
Choose a file
Please upload a copy of the child's immunization record.
Cancel
of
PLEASE DO NOT ALLOW THE CHILD TO BRING A CAMERA, PHONE, or MONEY. These items are not needed at camp.
The person signing below certifies that the information included in this application is correct. It is also understood that submittal of this application is simply a part of the application process. For The Children Abilene will notify you in email form letting you know the status of your application.
Electronic Signature of Parent/Guardian
*
First Name
Last Name
Relationship to the Child
*
Today's Date
*
-
Month
-
Day
Year
Date
Back
Next
Medical Release
This health history is correct so far as I know, and the above named minor has permission to engage in all prescribed program activities, except as noted. The undersigned do hereby authorize the directors of Royal Family Kids Camp or such substitute as they may designate as agent for the undersigned to consent to an X-Ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the above minor which is deemed advisable by and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp or elsewhere. This authorization will remain effective while the above minor is in route to and from or involved or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Director of Royal Family as legal guardian/social worker/other. I give my permission for:
Camper's Legal Name
*
First Name
Last Name
to attend Royal Family Kids Camp, sponsored by Fountaingate Fellowship, during the week of July 28th to August 1st, 2025.
Electronic Signature of Parent/Guardian
*
First Name
Last Name
Today's Date
*
-
Month
-
Day
Year
Date
PLEASE SUBMIT A COPY OF THE CHILD'S MEDICAID CARD WITH THIS CAMP APPLICATION
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
SUBMISSION
This completes the camper application. Our child placement team will begin contacting caregivers around the beginning of May. If you have questions, you can each out to us at royalfamilykids@ftcabilene.org
Submit
Should be Empty: