2026 Camp TrUSt! Camper Application

2026 Camp TrUSt! Camper Application

Boys camp: July 31 - August 2 Girls camp: August 7 - August 9
Name of Child

First NameLast Name
Preferred Name for Name Tag at Camp
Gender
If you marked "other," please explain.
Child's Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Current Age
Child's Primary Language
Child's T-shirt Size
Caregiver's Name

First NameLast Name
Relationship to Child
Caregiver's Primary Language
Caregiver's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Caregiver's Email Address
example@example.com
Is your child assigned to a social worker?
Caseworker Information

If you answered "yes" to the previous question, please fill out their caseworker's information.
Caseworker's Name

First NameLast Name
Caseworker's Daytime Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Caseworker's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Caseworker's Email
example@example.com
DCFS/Foster Care Agency
Camper Information

Please fill this out honestly. This information will help us best serve your teen's needs. Please note that behavior questions are to help us gain a better understanding of your teen. The purpose is not to disqualify their ability to attend camp, but it will be used to match them with their counselor and tailor activities as needed.
Has your child attended Royal Family Kids Camp or Camp TrUSt before?
Names, if any, of other siblings applying to this camp (teen camp):
What are the two most important things we should know about your child?
What are your child's interests? (colors, activities, shows, movies, sports, hobbies, art, etc.). Please feel free to include anything else that would help us to get to know your child!

What activities is your child interested in?

Rows	Not sure	Not interested	Somewhat interested	Really interested
Archery
Paintball
Rock climbing
Zipline

Explain any unusual family circumstances that make camp especially important for this camper (for example: recent crisis, being moved in foster placement, economic hardship, severe neglect, etc.)
Has your child moved homes while in foster care?
If so, how many times has your child been moved?
What method(s) of connecting, correcting, and empowering works well with this child?
Has your child received a copy of the Bible from us AND still has it? (pictured below)

How often does your child display the following behaviors?

Rows	Often	Sometimes	Not At All
Agressiveness
Sexual Acting Out
Runs Away
Biting
Eating Disorder
Hyperactive
Learning Disabilities
Lying
Nightmares
Night Terrors
Stealing
Tantrums
Withdrawn
Bedwetting

Please elaborate on any of these selections above:
Please explain how the behaviors mentioned above present themselves at school:

Prescription Medications

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.

Please list any prescription medications.

Rows	Name of medication	Purpose	Dosage	When is it taken?
1
2
3
4
5

Please type your name below as authorization for the camp's nurse to administer the above indicated prescription medication(s) during 7/31/2026 to 8/2/2026 (boys' camp) OR 8/7/2026 to 8/9/2026 (girls' camp).
Name

First NameLast Name
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Medical History

Please indicate all known allergies, illnesses, and/or physical limitations.
Allergies to any food or medications? If yes, please describe the reaction, and if none, type "none".
Does your child have seasonal allergies?
Breathing problems (if none, type "none").
Any illnesses and/or hospitalization for medical or psychiatric reasons? If yes, please explain. If none, type "none".
Does this child use assistive devices such as a hearing aid, leg/arm brace, etc.? If so, please explain. If not, please type "none".
Doctor's Name

First NameLast Name
Doctor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

To be signed at Registration at Nurses' Station on July 31st (boys) or August 7th (girls)
Printed Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Emergency Information

This information will only be used if there is an emergency.
Emergency Contact Name (primary person to be notified in case of emergency)

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact's Relationship to Child
Emergency Contact Name (additional secondary contact not required):

First NameLast Name
Emergency Contact Phone Number (additional secondary contact not required)

First NameLast Name
Emergency Contact's Relationship (additional secondary contact not required)
Name of Person Authorized to Pick Up Child

First NameLast Name
Phone Number of Person Authorized to Pick Up Child
Please enter a valid phone number.Format: (000) 000-0000.
Name of Person Authorized to Pick Up Child (additional person not required)

First NameLast Name
Phone Number of Person Authorized to Pick Up Child (additional person not required)
Please enter a valid phone number.Format: (000) 000-0000.

Consent to Travel

This information should be shared with the child's caseworker and you should receive approval from the agency.
Child to travel with our camp, leaving from and returning to Mission Church, 82 Stratford Dr., Bloomingdale, Il (traveling by bus to Walcamp, 32653 Five Points Road, Kingston, Il 60145). The duration of the trip is July 31-August 2, 2026 (boys) OR August 7-9, 2026 (girls). As legal guardian per the "Normalcy Parenting and the Reasonable and Prudent Parent Standard" I give my child consent to travel to camp. By typing your name below, you are also agreeing that you will get the required approval from your child's caseworker for your child to travel if needed.
Caregiver's Name

First NameLast Name
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Acknowledgement of Risk and Assumption of of Responsibility / Liability Waiver / Hold Harmless
I understand that I may participate in activities in Walcamp programs, which include: Archery, Boating, Swimming, Ziplining, Rock Wall Climbing, or other Activities. As a participant engaged in such activities always by my own choice, I assume the risk of injury. I understand the program has taken precautions to provide proper organization, supervision, instruction, and equipment for each activity, however, it is impossible for the program to guarantee absolute safety. Also, I understand that I share responsibility for safety.
Child's Name

First NameLast Name
Caregiver's Name

First NameLast Name
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Verification

By submitting this document and signing below, I certify that the above information is true and correct to the best of my knowledge.
Signature
Caregiver's Name

First NameLast Name
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Rows	Yes	No
Sun block
Insect repellent
Band-aids
Antiseptic ointment
Antiseptic wash
Anti-itch cream
Cough syrup
Decongestant
Antihistamine
Upset stomach medication
Acetaminophen (Tylenol)
Ibuprofen (Motrin)
Cough drops

2026 Camp TrUSt! Camper Application

Caseworker Information

Camper Information

Medications

Prescription Medications

Please type your name below as authorization for the camp's nurse to administer the above indicated prescription medication(s) during 7/31/2026 to 8/2/2026 (boys' camp) OR 8/7/2026 to 8/9/2026 (girls' camp).

Medical History

To be signed at Registration at Nurses' Station on July 31st (boys) or August 7th (girls)

Emergency Information

Consent to Travel

Acknowledgement of Risk and Assumption of of Responsibility / Liability Waiver / Hold Harmless

Verification