Camper Registration - Camp Milton 2026

Camper Registration - Camp Milton 2026
Get ready for Camp Milton 2026!

We’re excited to have you join us for an unforgettable week. This year, we’re celebrating __________T.O.____________, making new memories while honoring the moments that bring us together. This form is your first step in joining the fun! We encourage campers and their parents/guardians to complete it together.

📅 Arrival: Monday, June 8th at 10:00 AM

🎉 Closing Ceremonies: Saturday, June 13th at 9:30 AM

Get ready for an incredible week of fun, friendships, and memories that last a lifetime!

Campers must meet the following criteria to attend Camp Milton:

Medical Eligibility: Campers must have a diagnosed neuromuscular disease, such as Duchenne (DMD), Becker (BMD), Myotonic (DM), Limb-Girdle (LGMD), Facioscapulohumeral (FSHD), Congenital (CMD), Distal (DD), Oculopharyngeal (OPMD), or Emery-Dreifuss (EDMD) muscular dystrophy.

Age Requirements: Campers must be at least 6 years old or completed Kindergarten at the youngest.

Upper Age Limit: Campers may attend camp through the summer immidiately following their high school graduation.

Age Restriction: Campers cannot attend camp if they are over the age of 18, even if they are still enrolled in high school.
Camper's Name*

First NameLast Name
Camper's Date of Birth*

MonthDayYear
Date
What will the camper's age be on June 8th, 2026*
Parent / Guardian Name (this will be our primary contact during the week of camp)*

First NameLast Name
Parent / Guardian Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Email*
Camper drop-off is Monday, June 8th at 10:00 AM. If you are planning to drop your camper off at a different time, please list that here:
Emergency / Backup Contact (This should be someone other then the parent / guardian listed above)*

First NameLast Name
Emergency / Backup Contact Phone Number*
Please enter a valid phone number.

New Campers

We're so excited to welcome you to the Camp Milton Family!
In detail and using names - how did you hear about Camp Milton? (This information is so helpful to us!)*

Returning Campers

We're so excited to have you back at Camp Milton!
Who was your counselor the last time you attended camp?*
Would you like to keep the same pairing for this year?

YesNoUnsure
If you would like to elaborate on your response please do so here

Camper Medical Info

This helps us ensure we provide the best care possible to your camper!
Camper's past medical history - all diagnosis please, this might be your most typing - please give us details so we are well prepared at camp
Does your camper have health insurance?*

YesNo
Health insurance provider*
Policy holders name*
Policy Group Number*
What is the name of your campers primary care physician*
Physicians phone number*
List any known allergies your camper has
List any dietary restrictions your camper has
Has your camper seen a psychiatrist, psychologist, or other mental health professional in the last 3 years?*

YesNo
Please elaborate.
Has your camper been exposed to any communicable diseases in the past 3 months?*

YesNo
Please elaborate: *
Please upload a copy of your campers immunization records*

Cancelof
I understand that Camp Milton will require a negative COVID-19 test (antigen / rapid or PCR) within 72 hours of arrival to camp if my camper has any symptoms.*

I understand
Does your camper take medication?*

YesNo
CAMPERS MEDICATIONS 1.Medication name 2. What it treats for camper specifically 3. Dose 4. Frequencies and when the medication is taken. Please include meds taken on an as needed basis and when to administer them!!
I.E. "Wellbutrin, stabilizes his mood, 100mg, 2x daily, morning and night". HAVING THIS FILL OUT WELL HELPS SO MUCH WITH ARRIVAL AT CAMP!!!!
List any other medical information Camp Milton staff should know about your camper - this includes mental health information

I, as the parent/legal guardian of the camper named in this registration, authorize their participation in Camp Milton. I acknowledge that all information provided in this form is accurate to the best of my knowledge.
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Camper Registration - Camp Milton 2026

Camper Info

New Campers

Returning Campers

Camper Medical Info

Medical Info Continued

Getting to know your camper