2026 Royal Family KIDS Wilsonville CAMPER Application

2026 CAMPER REGISTRATION FORM

Royal Family KIDS Camp is a program of For The Children
Sponsoring Church Name: Community of Hope Church

Sponsoring Church Address: 27817 SW Stafford Rd, Wilsonville, OR 97070

Phone Number: (503) 476-1455

Camp Dates: July 20th - July 24th, 2026

Camper Applications Due: June 1st, 2026
This form should be completed by the caseworker/social worker and/or the foster parent(s) or parents/guardians. This form must be completely filled out (where required/applicable). We rely on the information you provide to best serve your camper during the week of camp.
Who is filling out this form?*

First NameLast Name
Your Phone Number*
Your Email*
example@example.com
Relationship to Camper?*

Social Worker/CaseworkerBiological ParentAdoptive ParentFoster/Resource ParentOther
Camper Informtion:
Full Legal Name of Camper*

First NameMiddle NameLast Name
Preferred Name/Nickname of Camper
Gender of Camper*

MaleFemale
Age of Camper: *
Date of Birth: *

MonthDayYear
Date
Estimate of Developmental Age of Camper
Upload picture of Camper here if available

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Choose all that apply:*

This is Campers first time at Royal Family KIDS CampCamper has been to camp beforeCamper has siblings that are coming to campCamper has siblings that have graduated from or previously been to camp (not coming this year)Other
Name of Siblings if attending camp
Child is currently living with: *

Biological Parent(s)Adoptive Parent(s)Foster Parent (Non-Relative)Foster Parent (Relative)Guardian(s)Kinship Caregiver(s)Group HomeResidential Treatment CenterOther
(Primary) Name of Person Child is Living With: *

First NameLast Name
Best phone number to to contact primary caregiver*
(Secondary) Name of Person Child is Living With:

First NameLast Name
Best phone number to to contact secondary caregiver
Address Where Child is Living: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail of Primary Contact:*
example@example.com
Social Worker/Case Worker Name:

First NameLast Name
Social Worker/Case Worker- Phone Number:
Social Worker/Case Worker- Email:
example@example.com
Emergency Contact*

First NameLast Name
Relationship (of Emergency Contact)*
Phone Number (of Emergency Contact) *
Child T-Shirt Size*

Child XSAdult SChild SAdult MChild MAdult LChild LChild XLChild XLOther
Child Pant Size

Child XSAdult SChild SAdult MChild MAdult LChild LAdult XLChild XLOther
Child Shoe Size
(Ex: 3.5y or 13.5c or 8mens)
Childs History
Number of known placements for foster child (including current placement)
Does child have current visitations with biological parent(s)

YesNoUnknownNot ApplicableOther
Explain any circumstances that make camp especially important for this child (ie. recent crisis, placement change, separated from siblings, exposure to adverse childhood experiences, etc.)*
Please mark ALL THAT APPLY to child's current emotional or behavioral concerns (this information helps us to better know how to support your camper during the week of camp)*

AggressiveBitingBedwettingEating disordersLearning delays or disabilitiesHyperactiveSpeech DelaysNight Terrors, Nightmares, Frequently awakes in the nightStealsFrequently lies or exaggerates reality (dramatic)Runs awayTantrums or physical outburstsSexually acting outActs much more mature than their ageActs much more immature than their ageAudio (hearing) sensory issuesTactile (touch) sensory issuesLikes to spin, jump or be constantly movingWiggles or fidgets when trying to sit stillHas difficulty following directionsWithdraws or gets quiet when upsetHas emotional or physical outbursts when upsetHides or hoards food or other itemsDifficulty swallowing or chokes frequentlyClumsy, falls or crashes into things oftenNeeds to fidget or draw while listeningChews or bites nails excessivelyOther
Please provide any additional / relevant details regarding emotional or behavioral concerns for this child (ie. how often or what it looks like)
Other concerns that I would like to discuss with the camp Child Specialist/Licensed Counselor prior to camp:
Has the camper been the victim of sexual abuse? *

YesNoUnknown
Has the camper been the victim of physical abuse? *

YesNoUnknown
How long has the child been in the care of their present placement? (if applicable)
If the child's case is closed, when did it close?
Camper Details
Please tell us a little about your camper. (This helps us encourage enjoyable and confident participation in activities at camp).*

Likes to swimLikes musicLikes to draw or is artistic and creativeLikes sportsLikes animalsLikes to fish or wants to tryMakes friend easilyNeeds help making friendsLikes to try new thingsNeeds help trying new thingsIs very active and energeticIs less active and prefers to do things that are more quiet and reservedLikes to build things (legos, wood projects, etc.)Likes to readHas a funny sense of humor or is wittyIs very helpful and likes to help othersIs very neat and tidyIs more slopp/messy - has a hard time keeping track of things or loses things easilyIs a great eater (different than unhealthy over eating)Is a picky eaterPrefers smaller groups and one on one activitiesLikes big groups and noise and activityLikes to act or be involved in plays/dramaIs a great story teller (different than lying)Can shower and bathe without assistancePrefers total darkness at night when sleepingNeeds some assistance bathing, washing hair etc. (note: the child is never alone at camp with another child or an adult - we do have alternative methods of helping a child shower/bathe with supervised assistance to their needs)Is afraid of the dark at nightOther
Any other characteristics unique to this child you'd like us to know:
Child's Swimming Ability:*

PoorFairAdvancedUnknownOther
Does this camper have any learning diagnoses or disabilities?
Potential triggers for this child?
Coping skills/techniques that are effective for this child? (or not effective)
Health & Medical History
Please mark all of the following medical conditions that apply for this child:*

NO MEDICAL CONDITIONSAsthmaDiagnosed eating disorderHeart conditionHypoglycemiaBack injuryDiabetesSeizure Disorder / EpilepsyHearing aids or hearing impairmentRespiratory or breathing problemsKidney IssuesFainting or dizzy spellsAnaphylactic shockSkin issues/rashes/eczemaHemophilia or Bleeding DisorderCerebral PalsyADHDAutismDepressionAnxietyJuvenile Idiopathic ArthritisSystemic Lupus ErythematosusDevelopmental DelaySickle Cell DiseaseCrohn's Disease or IBSCancerFetal Alcohol SyndromeMuscular DystrophyCeliac DiseaseAnemiaEncopresis/ConstipationEnuresis/Urinary IncontinenceOther
Does your child have any of the following accessibility, mobility, or medical devices?*

NO MOBILITY OR MEDICAL DEVICESWheelchairAnkle-Foot OrthosesBack BraceWalker or CaneHearing AidsGlasses or ContactsAAC (communication) DeviceOther Orthopedic BracesNebulizerInsulin Pump or Glucose MonitorSpecialized Feeding EquipmentCast/Splint/SlingChest Wall Oscillation Vest
Please explain any relevant/helpful information regarding this child's medical needs or devices.
Are any activities to be restricted?
Does the child have any of the following known major allergies?*

NO KNOWN ALLERGIESBeesOther insect allergiesSeasonal (please list below)Food allergies (please list below)Dairy allergiesDrug allergies (please list below)Gluten (please indicate sensitivity or diagnosed celiac)Other
Please detail above allergies- be sure to describe if any allergies are anaphylactic:
Does the child have prescribed Epinephrine?

YesNoOther
Does the camper have asthma?

YesNoThe camper has an inhaler that will be sent to camp with them.
Prescription Medications

ALL MEDICATIONS FOR CAMP MUST BE PROVIDED IN THEIR ORIGINAL CONTAINER WITH THE APPROPRIATE PRESCRIPTION LABEL (IF APPLICABLE) AND CLEARLY PRINTED DOSAGE INSTRUCTIONS FOR THE CAMPER.
Does the child take any medications? *

YesNo
Please list all medications, dosage & reason for taking.

Medication NameDosage Diagnosis or Reason for taking
Medication NameDosage Diagnosis or Reason for taking
Medication NameDosage Diagnosis or Reason for taking
Medication NameDosage Diagnosis or Reason for taking
Medication NameDosage Diagnosis or Reason for taking
Medication NameDosage Diagnosis or Reason for taking
Does this child have any challenges taking medication?

YesNo
If yes, please explain and offer any suggestions to best support them at camp.
Prescribing Doctor's Name*

First Name Last Name
Doctor Phone Number*
I understand that it is my responsibility as caregiver to make sure that all instructions on medications are clear and that the necessary dosage is adequately supplied for the duration of camp. I hereby authorize the camp nurse(s) to administer the above medication(s) at camp.*

YesNo
Has the child had any serious illness, injuries, or medical operations in the last three years?*

YesNo
Please list illness or operations:
Other medical conditions we need to know about the camper:
Authorized Person(s) to Pick Up Child:

Authorized person(s) will need to show identification and be cleared with Social Worker/Case Workers to pick up child. Children will NOT be released to unauthorized or previously cleared person(s). PLEASE ARRIVE AT PICK UP LOCATION (the pick up location, date, and time to be announced)
Person Authorized to Pick Up Child: *

First Name Last Name
Phone Number*
Person Authorized to Pick Up Child:

First Name Last Name
Phone Number
Person Authorized to Pick Up Child:

First Name Last Name
Phone Number
Medical Authorization and Release:

Must be signed by Case Worker/Social Worker or Legal Guardian
By selecting “Yes” for any of the over-the-counter medications listed below, I authorize the RFKC Nurse to administer those products to my child during the week of camp in accordance with the manufacturer’s directions, the Oregon Nurse Practice Act, and camp medical protocols, unless otherwise noted in writing by a parent/guardian/social worker or a licensed healthcare provider. I understand that no over-the-counter medication will be given unless “Yes” is selected for that medication, and that selecting “No” means that product will not be administered under any circumstances. I further understand that medications will be administered only as medically appropriate and that the RFKC Nurse may contact a parent/guardian/social worker or the child’s healthcare provider if clarification or verification is needed.

By selecting “Yes” for any of the over-the-counter medications listed below, I authorize the RFKC Nurse to administer those products to my child during the week of camp in accordance with the manufacturer’s directions, the Oregon Nurse Practice Act, and camp medical protocols, unless otherwise noted in writing by a parent/guardian/social worker or a licensed healthcare provider. I understand that no over-the-counter medication will be given unless “Yes” is selected for that medication, and that selecting “No” means that product will not be administered under any circumstances. I further understand that medications will be administered only as medically appropriate and that the RFKC Nurse may contact a parent/guardian/social worker or the child’s healthcare provider if clarification or verification is needed.*

Rows	Yes	No
NSAIDS (Ibuprofen)
Acetaminophen (Tylenol)
Sunblock
Insect Repellent
Triple Antibiotic Ointment
Hydrocortisone or Benadryl/Diphenhydramine (Anti-Itch Cream)
Burn Gel (Lidocaine Hydrochloride Gel)
Lip-Balm/Vaseline
Eye Drops (Normal Saline)
Throat Lozenge (Cough Drops)
Calcium Carbonate (Tums)
Antihistamine (Allergy Medication)
Normal Saline Wound Wash
Insect Sting Swabs (Benzocaine Swab)

**Please note that Wilsonville Royal Family Kids Camp may supply either generic or brand-name versions of the over-the-counter medications listed above. If a parent/guardian desires a specific medication (or specific brand or formulation) to be administered, they must provide that medication to the camp nurse(s) at check-in on July 20th. All medications must be in the original container, and the dosage instructions must match the camper in order to be accepted.
Is this child up to date on all required (school-mandated) immunizations?*

YesNoUnsure
By typing an elctronic signature below I agree to all terms, conditions, and authorizations in this form.
Printed Name of Legal Guardian/ Caseworker or Social Worker *

First NameLast Name
Today's Date*

MonthDayYear
Date
Signature of Legal Guardian/ Caseworker or Social Worker *
Please attach any relevant documents that may be helpful: IEP/504 plan, behavior plans, safety plans, etc.

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Search Policy:

For the success and safety of all camp attendees, it may be necessary to search a child’s bags or property to assure they have everything they need for a successful week (i.e. clothing, swimsuit, toiletries, etc.) and a safe week (i.e. no candy, electronics, tobacco products, or other inappropriate items.) Any Illegal items will be turned over to proper authorities be that the Guardian, Social Worker or Law enforcement and the Guardian will be informed. Any other items removed will be returned directly to the legal Guardian at registration, if possible, or at the end of the camp.
We look forward to spending time with your child at CAMP! Contact us if you have any questions.
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2026 CAMPER REGISTRATION FORM

This form should be completed by the caseworker/social worker and/or the foster parent(s) or parents/guardians. This form must be completely filled out (where required/applicable). We rely on the information you provide to best serve your camper during the week of camp.

Camper Informtion:

Childs History

Camper Details

Health & Medical History

Prescription Medications

Authorized Person(s) to Pick Up Child:

Medical Authorization and Release:

Search Policy:

We look forward to spending time with your child at CAMP! Contact us if you have any questions.