2026 UTAH Royal Family KIDS Camper Application
CAMP DATES: JULY 29TH-AUG 2 2026
IMPORTANT INFORMATION
Thank you for your interest in Utah Royal Kids (URK) camp. This link will take you to an application to register your child(ren) for URK 2026, camp dates are Wednesday, July 29, 2026 thru Sunday, Aug 2, 2026. The application will ask for information about your child's medical needs, any eating disorders, child and family history, behaviors as well as other questions to ensure the safety and security of your child while they are at camp. A head shot photo of the child will need to be uploaded along with the application. All information is kept confidential. Please fill out ONE APPLICATION FOR EACH CHILD you are registering. Children ages 7-11 who are, or were, involved in the child welfare system, including those that have been adopted, are eligible for camp. However, priority is given to returning children and children currently living in a foster home. Please note completing the application does not guarantee the child a spot at camp. You will be notified if the child has or has not been guaranteed a spot to camp no later than end of June. The number of children we can take to camp is determined by the number of volunteers we have so please be patient with us as we get confirmation letters out when children are guaranteed a spot. If you have any questions please contact our Child Placement Coordinator, Christine McAtee at 801-808-9069 or childplacementcoordinator@utahroyalkids.org Thank you and we look forward to seeing you in July 2026.
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Childs Name
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First Name
Last Name
Childs Preferred Name, if different from legal name:
Preferred First Name
Childs Gender:
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Male
Female
Date of Birth:
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-
Month
-
Day
Year
Date
Age at time of camp:
Childs emotional age
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Childs current grade level:
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Child's T-shirt size
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Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Childs shoe size (please specify if kids or adults size)
Childs pant size
Childs Ethnicity
White
Asian
African American
White Hispanic
Native American
Pacific Islander or Native American
Prefer not to answer
Date of camp
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Month
-
Day
Year
Date
Is the child a returning RFK camper?
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Yes
No
If yes, please tell us what year(s) and what camp
Please upload a recent head shot color photo of this child (within the last six months). Upload a JPG, or PNG ONLY. You will not be able to upload a photo larger than 1 MB (or 1024 KB) in size.
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of
Child's home environment
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Foster Home
Adoptive Parents
Group Home
Residential Treatment
Relative
Biological Parent(s)
Other
Does the child have a sibling/relative who would like to attend this camp
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Yes
No
If the child has siblings/relatives wanting to attend this camp, please tell us who they are.
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Name of person filling out application:
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First Name
Last Name
Relationship of person doing app for child:
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Phone Number of person doing app
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Email of person doing app
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example@example.com
Parent/Guardian Information
Parent/Legal Guardian, same as person doing app
Parent/Legal Guardian Name:
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First Name
Last Name
Relationship of parent/legal guardian to child:
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Phone Number of parent/legal guardian
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Email of parent/legal guardian
*
example@example.com
Address of legal Guardian:
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Street Address
Street Address Line 2
City
State
Zip Code
What date was the child placed in their current home:
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How many foster or residential placements has the child had, including current home:
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Emergency Contact, same as person doing app
Emergency Contact
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First Name
Last Name
Emergency Contact Phone #
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Emergency Contact email
*
example@example.com
Authorized adult to pick child up at Good Shepherd Lutheran - 8575 S 700 E Sandy, Utah
Pick up time is 11:00 - 12n SUNDAY, Aug 2nd 2026
Authorized adults picking the child up will need to show photo Government ID*
*
Caseworker/Child Placement Agency Information
Childs placement/caseworker agency name:
Childs placement/caseworker name:
First Name
Last Name
Childs placement/caseworker phone #
Child placements/caseworker email
example@example.com
CASA (Court Appointed Special Advocate) name, if the child has one
First Name
Last Name
CASA Phone #
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Background/Behavior Information
Please fill this out to the best of your ability. We as RFKC staff want to make sure your child has a safe, healthy, fun time at camp. This information is extremely helpful!
Please tell us about this child's history or story. Was the child physically or sexually abused? What situations may have been challenging for this child before living in your home? How long and Why was this child placed in foster care?
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We expect and look for great things in each and every child. We also know that many of these children have had difficulties in their past which have shaped their present reality. Please give some information about his or her past so we can better understand this child.
Please mark all that apply to child's current emotion or behavior:
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Has Nightmares
Difficulty sleeping
Bed wetting
Aggressive behavior
Bites self or others
Stool issues
Tells lies
Runs away
Steals things
Has anger issues
Withdraws
Learning difficulties/disability
Sensory issues
Sensitive to loud noises
None of these apply
Other
Please tell us what triggers the nightmares and what may help calm the child?
Does the child wear pull ups? We recognize that accidents may occur and handle such situations with discretion, ensuring the child is treated respectfully and without embarrassment.
Yes
No
How often does the child bite and what triggers it?
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Please tell us how often the child lies and what triggers it?
Please explain what may trigger this behavior and what helps in managing it.
How often does this child steal things?
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Please explain what may trigger this behavior and what helps in managing it.
How often does this child withdraws? What may trigger this behavior? What helps the child to not withdraw?
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Please explain what sensory issues the child has. What triggers it and what helps the child?
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Please explain the Childs sleeping habits and what helps the child sleep?
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What are "triggers" for the aggressive behavior and what they might look like? Please describe possible alternatives to help calm the child.
Please explain what may trigger this behavior and what helps in managing it.
How often does the child have stool issues and will the child ask for help?
Please let us know what situations may cause the child to run away?
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Please explain what may trigger this behavior and what helps in managing it.
Please explain the learning difficulties and how we can help the child:
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ie: Hearing impairment, Vision impairment, Dyslexia or reading difficulties. If there are any learning difficulties that will affect this camper's week or if there is information that would help us make camp better for your child please explain.
Please explain what noises the child is sensitve to and what helps the child?
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I.e. headphones, earplugs etc.
How good of a swimmer is the child (check all that apply)?
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Not a good swimmer at all
Needs assistance of a floating device
Somewhat of a good swimmer
Is a great swimmer
Has to stay in shallow waters
Other
How would you describe the child's hyperactivity(check all that apply)?
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Very calm
Somewhat hyperactive
Always hyperactive
Trouble paying attention
Overly active
Excessively fidgety
Moves about constantly
Takes meds to calm him/her
Other
Please let us know if -or how- the child may act out sexually?
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Does not act out sexually
Touches self
Touches other children
Makes inappropriate sexual comments
Flirts or pays inappropriate attention to others
Has sexual history
Other
Please explain any sexual history and what may trigger the acting out.
Please explain what may trigger this behavior and what helps in managing it.
Please tell us about the child's attention span and/or hyperactivity. What makes the child hyper or fidgety and what helps this behavior?
i.e. Terrific attention span, Sometimes needs redirecting, Constantly needs redirecting, Short attention span, very hyper, constantly fidgety.
How does this child rate on the Autisim scale:
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Mild
Moderate
Extreme
Does not have signs of autisim
Explain the child's communication skills:
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ie: Great listener, very expressive, likes to talk a lot, very quiet, communication difficulties, lack of interest in other people, lack of eye contact, difficulty in understanding other people's feelings and expressing their own, limited response to social interaction
Any additional behavior information you feel our staff or counselors need to know while your child is at camp? Please share anything that might be helpful!
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Medical History + Medication Information
Physicians Name
*
First Name
Last Name
Physicians Phone #
*
Childs medicaid/insurance number
*
Is child current on vaccinations?
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Yes
No
Please explain if child is not current on vaccinations.
Illnesses and Medical Complications Past or Present (check all that apply)
*
Respiratory Problems
Muscuoskeletal Allergies
Food Allergies
Medicine Allergies
Topical Allergies (lotion, sunscreen, etc.)
Dizzy Spells and/or Fainting
Foot Problems
Back Problems
Seizure Disorders
Anaphylactic Shock
Balance Problems
Asthma
ADD or ADHD
Hypoglycemia
Heart or Circulation Problems
Pulmonary Edema
Hay Fever
Poison Oak/Poison Ivy Allergies
Type 1 Diabetes (previously insulin-dependent)
Type 2 Diabetes (previously non-insulin dependent)
Insect Bite Allergies (i.e. mosquitoes, bees, wasps, etc.)
Recent Surgery
Recent Broken Bones
None
Other
List all known allergies to food, plants, medications, animals, etc.
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Please explain an include any and all additional medical issue we should be aware of.
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Please check YES or NO giving us approval to administer the medications listed below. This form must be completely filled out by the primary caregiver who signs below, or camper may not attend camp.
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Yes
No
Acetaminophen (Tylenol) 325mg tabs
Acetaminophen Liquid (Tylenol) 160mg/5ml
Ibuprofen (Advil) 200mg tabs
Ibuprofen Liquid (Advil) 100mg/5ml
Diphenhydramine (Benadryl) 25mg tabs
Diphenhydramine Liquid (Benadryl) 12.5mg/5ml
Dextromethorphan (Delsym) 15mg/5ml
Calcium carbonate chewable (TUMS)
Cough Drops (generic)
Phenol spray (Chloraseptic spray)]
Triple antibiotic ointment (neosporin)
Hydrocortisone cream 1%
Hydrogen Peroxide OTC
Solarcaine topical
Immodium (anti diarrhea)
Pepto Bismal liquid and chewables (anti nausea)
Calamine or Caladryl Lotion
Lice treatment/shampoo
Bactine (first aid/antiseptic/pain reliever)
Sunblock/Sunscreen
Lip Balm
Melatonin
Will your child be bringing Prescription and/or Over-the-Counter Medications?
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Yes
No
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. I authorize RFKC medical staff to administer the medications. IMPORTANT: All Medications must be in original container with pharmacy or over the counter label on it. DO NOT pack medication in luggage, you will turn it into the nurse at registration.
Yes, I understand it is my responsibility to supply clear instructions and medical dosage needed and agree for RFKC medical staff to adminster the medications.
Please list ALL prescription and/or over-the-counter medications the child will be bringing to camp.
Any additional information we need to know about any prescription drugs, vitamins, or over-the-counter medications sent to camp - or - additional meds if any.
*
ie: Epi pen, Melatonin, sunscreen, bug spray, etc.
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What specific activities should we ENCOURAGE your child to do while at camp?
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What specific activities should be DISCOURAGED while at camp?
*
Please tell us what this child's interests, passions, loves, are so our Staff can make camp even more special. What are their strengths, positive traits, and characteristics (i.e. Loves sports, crafts, favorite food, favorite color, favorite animals...whatever!)
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How did you hear about Royal Family KIDS Camp
Stay Connected through our Mentoring Club
Mentoring Club is designed for any child that has attended Royal Family KIDS Camp
Throughout the school year campers and their mentors attend a once a month mentoring club meeting. Mentoring club is a place where a camper can reconnect with many of the participating staff members from camp as well as build lasting friendships with the other mentoring club kids. Club KIDS enjoy the same songs, games, and friends they met at camp, which reinforces stability and character strength in their lives. Are you interested in finding out how this child can be part of the Mentors Program throughout the 2026-2027 school year?
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Yes - Please register the child for mentoring.
Maybe - Please send me more information!
No, thank you
Authorized Signature: I have read the above "Permission to travel, waiver and release of liability" in the Terms & Conditions and by signing below I agree. It is my intention to exempt and relieve Good Shepherd Lutheran, For The Children, and Royal Family Kids Camp from all and any liability. Sign by using your mouse pad or touch screen.
*
There are three For The Children Chapters in Utah offering, Royal Family KIDS Camp and Mentoring programs.
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