• Child Application

    Child Application

    Camp Dates: June 15 To June 19, 2026

  • NOTE: Many fields require an entry, if the field does not apply, enter "DNA".

    ("DNA": Does Not Apply)
  • Relationship to Child*
  • Incarcerated Parent(s)?

  • Child's Information

  • Is child a returning RFK camper*
  • Gender assigned at birth*
  • Birthdate*
     - -
  • Child's grade fall of 2026.*

  • Emotional Age*
  • Child's T - Shirt Size*

  • Interest in Mentoring Club: 2026-2027 School Year?

  • Mentoring Club?*

  • Parent/Guardian Information

  • Best home description?*
  • Approximate date of placement in current home?*
     - -
  • If applicable: Date of Adoption
     - -

  • Number of placements for the child including current home

  • Parents or Legal Guardians

    Person(s) with whom child resides

  • Parent/Guardian #1

  •  -

  • Parent/Guardian #2

  •  -

  • Case Worker/Child Placement Agency Information

  •  -

  • Background/Behavior Information

    Please fill this out to best of your ability. We as RFK staff want to make sure your child has a safe, healthy, fun time at camp. This information is extremely helpful!

  • Why attendance at RFKC be important?

    Why would you like to see him or her attend camp?
  • Swimming ability?*

  • Bed Wetting

  • Bed wetting?*
  • Aggressive behavior?*
  • Eating disorders?*

  • Hyperactivity?*
  • Attention span?*
  • Learning difficulties?*

  • lying?*
  • Night TERRORS.*
  • Nightmares*
  • Running away?*
  • Sexually acting out?*
  • Stealing?*
  • TANTRUMS or ANGER issues?*
  • Withdrawn?*

  • HISTORY/STORY: Please share this child's history or story so we can undrstand how to give him or her an even MORE amazing week at camp!

  • History

    **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?

  • RFK experience

    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?

  • MEDICAL HISTORY + PRESCRIPTION MEDICATION INFORMATION.

  • Date of Last Physical*
     - -
  • Illnesses and Medical Complications Past or Present ( check all that apply)*

  • Prescription Medications

    I understand that it is my responsibility as a caregiver to make sure that all medications are clear and that the necessary dosage is adequately supplied for the duration of camp (Monday June 15, 2025 to Friday 19 2026) I authorize RFKC medical staff to administer the medications.

  • Additional Medication Information

    nformation we need to know about the above prescription drugs, Vitamins, or OVER THE COUNTER MEDICATIONS sent to camp - or additional meds if any.

  •  -
  • In what medical system does the child participate*

  • Immunizations not up to date:

  • Please SUBMIT this form, then go back to the main menu, and select the REQUIRED CHILD PERMISSIONS FORM from the menu, click PRINT and fill out the form and mail to the address specified on the form

     

  • Should be Empty: