Overnight Camper

Overnight Camper
We're so excited you'll be camping with us this summer! To prepare for your overnight session, please complete all the questions in this form carefully and accurately.

This form should take about 15 minutes to complete, and will require e-signatures from both the adult filling out the form, as well as the camper. Document upload of a completed and signed physical exam from your camper's doctor and immunization records are required, so please have those ready before starting this form. If you have yet to, you can download and fill out those required medical forms here:

FORM 1: Camper Health History Form

FORM 2: Recommendations for Licensed Medical Personnel

Once you have completed this online form, you will receive a confirmation email with a PDF of your responses.

Camper Information
Camper's Name*

First NameLast Name
Camper's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Camper's Primary Care Doctor*
Primary Parent/Guardian

Person filling out this form, to receive a copy of your responses
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com
Emergency Contacts
Emergency Contact #1 Name*

First NameLast Name
Emergency Contact #1 Phone Number*
Please enter a valid phone number.
Emergency Contact #2 Name*

First NameLast Name
Emergency Contact #2 Phone Number*
Please enter a valid phone number.
The following adults are authorized to pick up my camper: *
Please list first and last name of all authorized adults
Additional information for emergency action (allergies/medicalconditions/medicine etc.):

Camper Health History Forms
The following 2 forms are required to proceed. If you have yet to, please download, fill out, scan, and reupload these forms here. FORM 2 requires a doctor's signature.

FORM 1: Camper Health History Form

FORM 2: Recommendations for Licensed Medical Personnel
Upload FORM 1: Camper Health History Form*

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Upload FORM 2: Recommendations for Licensed Medical Personnel *

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Upload FORM 3: Immunization Records*

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Camper Behavior Contract
Camper's Name*

First NameLast Name
Camp Session(s)*
I understand that my behavior and attitude are important to the success of the camp, both for myself and others. I understand that while attending camp, I must take responsibility for my actions and always act according to the Girl Scout Promise and Law. I agree to behave in the following manner:
1. I will always show respect for myself and fellow campers.
2. I will treat the camp property and its equipment with care and respect.
3. I will obey the camp rules and the directions of the staff and volunteers.
4. I will use words to settle disagreements and express my feelings in an appropriate way.
I have read and understand my responsibilities. I understand that failure to live by this agreement while at camp will result in disciplinary actions, and I could be sent home from camp at any time.
Camper's Signature*

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I have discussed this agreement with my girl/camper. I understand the contents of this contract and support its terms.
Parent/Guardian Signature:*

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Electronics Policy Agreement
We understand that cell phones and tablets are a part of everyday life for our campers, and when faced with leaving these things behind for a week of summer camp, it can become stressful. We do not permit electronics at camp as we have found that having them increases homesickness and does not allow the camper to fully engage in and enjoy the camp experience. Camp is a wonderful opportunity for our campers to disconnect from electronics and reconnect with nature as well as the people around them. Your camper’s health and safety are our top priority at camp. You are welcome to contact the Camp Director with any questions or concerns while your camper is with us.

Our Electronics Policy is as follows:
1. Cell phones and other electronics will not be permitted at camp.
2. Guardians can send handwritten letters or emails to their camper during their camp session. Our camp email is WelakaResidentCamp@gssef.org.
3. Campers are encouraged to write home via postal mail to make note of their feelings, triumphs, and struggles in real time while at camp, as well as conquer homesickness. Please provide stationery and pre-addressed envelopes with stamps for your camper.
4. In the event of an emergency or illness, the Camp Director or Healthcare Manager will contact guardians.
5. Campers will only be permitted to call home if deemed appropriate after the Camp Director or Healthcare Manager has contacted the guardians.
I, (parent/guardian) have read fully and discussed the Electronics Policy Agreement with my camper, (camper's name) and agree to follow the terms of this agreement with the understanding that failure to do so will result in the camper being dismissed from camp if not resolved.
Camper's Signature:*

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Parent/Guardian Signature:*

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Should be Empty:

Overnight Camper

Camper Information

Primary Parent/Guardian

Emergency Contacts

Camper Health History Forms

Camper Behavior Contract

Electronics Policy Agreement