2025 CAMPER APPLICATION RFKC SCOTTSDALE

Royal Family Kids Camp (RFKC) is a camp for foster, group home, and adopted children ages 7-11 to attend a 5 day camp in Payson, AZ.

IMPORTANT: WE ARE ON A WAITLIST FOR BOTH GIRL AND BOY CAMPERS AND THE CHILD IN YOUR CARE WILL BE PLACED ON A WAITLIST.

WE ENCOURAGE YOU TO LOOK INTO OTHER RFKC CAMPS THAT OFFER THE SAME EXPERIENCE, JUST A DIFFERENT WEEK!

WWW.AZHOPE.COM/CAMPS

Our goal is for every child to attend one of the RFKC camps offered during the summer. Please visit the website www.azhope.com/camps to find out about other camps that may have more slots available for your child to attend, including options for children 12+ to attend TRAC (Teen Reach Adventure Camp).

Camper Personal Info:

Camper Full Name *

First NameLast Name

Camper Preferred First Name:

Please take or upload a photo of your camper (focusing on their face):*

Choose one*

This is my camper's first year attending RFKC ScottsdaleCamper has previously attended RFKC ScottsdaleCamper has attended at a different RFKC

Gender*

MaleFemale

Birth Date*

MonthDayYear

Age on 6/8/2025*

Emotional Age*

T-Shirt Size (can run small):*

Grade entering in Fall 2025: *

If a sibling of this child is applying to camp, please tell us who that is:

This sibling is a...

If 2nd sibling is applying to camp, please tell us who that is:

This sibling is a...

If 3rd sibling is applying to camp, please tell us who that is:

Guardian/Caseworker Info

Parent or Legal Guardian #1 (this person will receive the email auto reply and future email correspondence regarding child)*

First NameLast Name

Parent or Legal Guardian #1 Email*

example@example.com

Parent or Legal Guardian #1*

Please enter a valid phone number.

Parent or Legal Guardian #1 Relationship to Child: *

Parent or Legal Guardian #2

First NameLast Name

Parent or Legal Guardian #2 Email

example@example.com

Parent or Legal Guardian #2

Please enter a valid phone number.

Parent or Legal Guardian #2 Relationship to Child:

Who is an authorized adult that may pick this child up after camp Friday June 13, 2025? **Government ID required***

Name and Cell Phone

SECOND authorized adult. **Government ID required***

Name and Cell Phone

Caseworker (will receive auto-reply email with camp information):*

First NameLast Name

Caseworker Email:*

example@example.com

Caseworker Phone:*

Please enter a valid phone number.

Caseworker Supervisor Information*

NamePhoneEmail

Home Mailing Address (For Camp Correspondence)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

At time of camp, how long will this child have been living in current home?*

This home is best described as...*

Total # foster or residential placements for child including current home:*

Get to know your camper!

Please tell us about this child's history or story. What situations may have been challenging for this child before living in your home? What circumstances is this child dealing with?*

Why would this child's attendance at RFKC be important? Why would you like to see him or her attend camp?*

If this child attended Royal Family KIDS' Camp in the past, what did he or she like about it? What positive changes or behaviors did you see upon their return home?

Please tell us what this child's interests, passions, loves, etc. are so our Staff can make camp even more special! (Loves sports, interested in horses, favorite color is purple...whatever!)*

How often does this child wet the bed at night?*

NeverRarelySometimesVery Routinely

If child does wet the bed, please explain (i.e. wears pull-ups, don't drink liquids after certain time, just need to be aware, etc.)

How often does this child have tantrums or anger issues?*

Does this child display aggressive behavior?*

Please explain aggressive behavior. (What may trigger aggressive behavior or to whom child is aggressive.)

Does the child deal with any of the following eating disorders or issues around food?*

If this child does have an eating disorder - or has other issues around food we should know about - please explain.

How would you describe the child's demeanor? (Calm, withdrawn, hyperactive... etc.)*

How often does the child lie?*

Please let us know how often this child has night terrors:*

Please let us know how often this child has nightmares:*

Please let us know how often this child runs away from a situation or from home:*

How often does this child steal things?:*

How often does this child withdraw?:*

Please let us know if - or how - this child may act out sexually:*

Touches selfTouches other childrenDoes not act out sexuallyOther

If this child does act out sexually, please explain:

Medical History

Does your child have any medical, emotional, or mental health conditions?*

YesNo

If yes, please explain:

List ALL known ALLERGIES to food, plants, medications, animals, etc.*

Please let us know if any of the following learning difficulties exist for this child.*

Please rate the child's swimming ability:*

Does not know how to swimVery poorWith assistance (floatie, standing water)Independent (can tread water/float)

What, if any, specific activities should be DISCOURAGED for medical reasons while at camp?

Date of last TDAP (tetanus) shot:

Has your child had any serious illness, injuries, or medical operations in the last three years? If yes, please explain*

MEDICATIONS

NON-PRESCRIPTION Medications / Treatments Release:*

ALL NON-PRESCRIPTION AND OVER-THE-COUNTER TREATMENTS ARE ALLOWED TO BE GIVEN TO THE CHILD WHILE AT CAMPOther: see below

Please explain or if there are any over the counter medications you do not consent for your child to receive (tylenol, benadryl, motrin, etc.)

I understand that it is my responsibility as a caregiver to make sure that all instructions are clear and that the necessary dosage is adequately supplied for the duration of camp (Monday June 9th- Friday June 13, 2025.) I authorize RFKC medical staff to administer the medications.*

Yes, I understand that sharing medical info, medications, and dosages are my responsibility. I will bring all medications in their original medicine or prescription containers.

Prescription or Over-the-Counter Medication #1

Name of MedicineDose Frequency (How often to take)

Prescription or Over-the-Counter Medication #1