2026 Summer Camper Paperwork

  • 2026 Summer Camper Paperwork

    Please complete all of the fields below so we can best support your camper in their summer experience.

  • Camper Paperwork Notes:

    • This form must be completed by June 1, 2026
    • This paperwork should be completed for each camper attending camp.
    • It includes camper health history & physical, authorization to medication at camp, emergency contacts and adults approved for camper pick up, buddy requests, and more.
    • When filling out the forms please be ready with the following: 
      • Health Insurance Information
      • PDF or image file of the following documents ready to upload:
        1. Physical Exam signed by a physician (this can be a Girl Scout Physical, school, or sports physical form) clearing your camper for camp. 
        2. Immunization Records
        3. Asthma or Allergy Action Plan (if applicable)
      • Your camper for the last part of the paperwork to review the camper code of conduct
  • Please check the camp your camper is attending this summer. Choose all that apply.*

  • Camper Information

  • Select all of the session your camper is attending at Camp Farnsworth:
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  • Medical History and Physical

    This information is reviewed by the GSGWM Girl Experience Team, Camp Director, and Camp Health Supervisor. Relevant information is shared when appropriate with GSGWM seasonal camp staff or health professionals. We apprecaite your honesty while completing these forms they are used to best prepare for and support your camper and not to screen or prevent campers from coming to camp. The more we know the better everyone's camp experience will be.
  • Camper's sex assigned at birth:*
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  • All immunizations as required for school are up to date:*
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  • Medical Injury or Illness History - Please indicate if any of these items apply:*
  • Medical Health History - Please indicate if any of these items apply, especially in the last two years:*
  • Has your camper started their menstrual cycle?*
  • Mental and Behavioral Health History - Please indicate if any of these items apply, especially in the last two years:*

  • Medications at Camp

  • Over the Counter Medications- Available at Camp

    I hereby give permission for Girl Scouts of the Green and White Mountains to administer the over-the-counter medications I indicated below if the health supervisor or other designated staff member deems it necessary to treat headache, upset stomach, fever, menstrual cramps, or insect bites/stings, or treat minor scrapes or injuries. Dosages will be administered according to directions of the medication or as directed in camp standing orders approved by a licensed physician.
  • Indicate each over-the-counter medication you approve your campers to receive while at camp. With this approval medication may be administered without additional contact to treat symptoms.*
  • Overnight Campers Additional Over-the-Counter Medications Available: Indicate each over-the-counter medication you approve your campers to receive while at camp. With this approval medication may be administered without additional contact to treat symptoms.*

  • Camper Medications- Brought to Camp by Family/Camper

    All medications brought to camp by campers, including prescription medications and vitamins, must be brought in original containers. All prescription medications or prescribed over-the-counter must be accompanied by a signed physician’s order (or medication permission form). This form must be signed by a physician.
  • Camper Medications (prescription medications, prescribed over-the-counter medications, emergency medications, & vitamins)*
  • Emergency Medications & Permission to Carry: Asthma Inhalers and Epinephrine Auto-Injectors should be accompanied by an Asthma or Allergy Action Plan AND verification that the camper has the skills and knowledge to safely possess and use the medication approved by a physician.*
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  • Allergies and Special Diets

    Camper allergy information is shared with all camp staff for the safety of your camper. List all food, drug, or environmental allergies, and their reaction and treatment. Be sure to list the allergen, and the reaction and treatment. Please also tell us non-allergic dietary needs.
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  • Health Insurance Information

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  • Authorization for Medical Treatment

    By signing, I attest that this health history and medical information is complete and accurate. I know of no reasons why my camper should not participate in activities except as noted. I understand that if my camper's health condition(s) or insurance should change, I will notify the camp.  I hereby give permission to the medical personnel selected by the camp to provide routine health care, to treat minor injuries or illness, and to administer medications as indicated- as directed in the standing orders by a licensed physician. In the case of an emergency or if I cannot be reached, I hereby give permission to the medical personnel selected by the camp to order x-rays, routine tests, treatments, to release any records necessary for insurance purposed and to provide or arrange necessary related transportation for my camper.  In the case of an emergency or if I cannot be reached, I hereby give permission to the physician selected by the camp to secure and administer proper treatment, including emergency services, transportation, anesthesia or surgery for my camper, and to release medical information to the camp director or designee for purposed of treatment. I agree to be financially responsible for any treatment provided in accordance with this permission.  I agree to indemnify the Girl Scouts of the Green and White Mountains (GSGWM) for any medical expenses incurred pursuant to this authorization and to hold GSGWM harmless with respect to medical care administered to my camper while in their custody. This completed form may be photocopied for trips out of camp.
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  • Contact Information

  • Parent/Guardian Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Emergency Contact Information

    Camp requires an emergency contacts, at least 18 years old, who may be contacted if parent/guardian(s) above are unavailable. Do not list the parent/guardian(s) listed above as the emergency contact.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Additional Pick-Up Person

    Please enter the names of additional people your camper may go home with. Campers may only be release to the listed parent/guardian(s), emergency contacts, or additional pick-up person(s) with confirmation of matching photo id.

  • Additional Information

  • Buddy Request

    Most Girl Scouts come to camp as an individual, but some choose to camp with a buddy. If your camper wants to be placed with a buddy at camp, you can indicate their name below.

  • Buddy Request Notes:

    • We can honor one reciprocal buddy placement if they are registered for the same program and week of camp. 
    • If a group/troop of Girl Scouts come to camp together and they are registered for the same program, we will often pair them up based on buddy requests but cannot guarantee that all troop members will be in the same program group (or sleeping arrangement for overnight camp).  

  • Program Credits/Cookie Dough

  • Please indicate if you camper is allowed to use their 2026 program credits earned in at the camp trading post.*

  • Summer Camp Activity Release and Code of Conduct

    We encourage you to read and review the code of conduct with your camper so they are prepared for their camp experience and have an opporutnity to sign the code of conduct with you.

  • Girl Scout Program Permission and Activity Release

    I hereby accept and abide by the provisions on the following statement: I will not hold Girl Scouts of the Green and White Mountains responsible for loss of personal articles my camper brings to camp. I have read the council policies, registration information and financial obligations and agree to abide by them. I request that my camper be allowed to participate in the activities described for the registered program and other camp activities deemed appropriate by the camp. I understand that activities at camp follow GSUSA Safety Activity Checkpoints, which may have age restrictions which impact my camper's participation. I understand that my camper’s participation in camp may include both inherent and unanticipated risks. Acknowledging that such risks exist, I hereby release and discharge Girl Scouts of the Green and White Mountains, its officers, agents, and employees from any and all claims of liability for personal injury or property damage this camper may suffer while participating in the activity, including, but not limited to any claim arising out of any condition of the premises at which the activity is held or the conduct of any person in connection with the preparation for, supervision of, or conduct of any activity, whether planned or unplanned. I specifically agree to release and hereby release Girl Scouts of the Green and White Mountains and the officers, agents, and employees of the camp for any negligence of the camp, or its officers, agents, or employees.
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  • Girl Scout Camp Code of Conduct

    Girl Scout camp gives campers an opportunity to grow, explore and have fun. It is our goal to help campers build the courage, confidence, and character to take the lead and realize the power within. To help strengthen this camp goal, we refer to the Girl Scout Promise and Law as our guiding principle and code of conduct.

  • Girl Scout Promise

    On my honor, I will try:

    To serve God* and my country,

    To help people at all times, and to live by the Girl Scout Law.

     

    Girl Scout Law

    I will do my best to be honest and fair,

    friendly and helpful,

    considerate and caring,

    courageous and strong,

    and responsible for what I say and do,

    and to respect myself and others,

    respect authority,

    use resources wisely,

    make the world a better place,

    and be a sister to every Girl Scout.

     

    We expect every camper and staff member at camp to model these behaviors, follow camp rules, and act as a sister to all camp participants. Campers who cannot follow these standards will receive a reminder of expected camp behavior. The camper will then develop a plan for changing their behavior. Behavior consequences are progressive and may include dismissal from camp. Should the negative behavior occur again, the camper will create a behavior modification plan with input from staff and parents/guardians. Should behavior continue after the development of a behavior modification plan, dismissal from camp without a refund is a consequence. Some actions are deemed to have a significant impact and will require immediate dismissal from camp without a refund. Physically and/or verbally abusive/harassing behavior, illegal drugs, marijuana, alcohol, tobacco, and clothing that promotes any of the above compromise our community and are not welcome at camp. Behaviors that are intentionally harmful, such as taunting, spreading rumors, excluding others from groups, endangering the safety of any camper, and verbal or physical aggression toward staff, adults, or campers may result in immediate dismissal from camp.

    Please review and sign below:

    • We have reviewed the Camp Family Handbook, and accept the policies and procedures outlined within.
    • We are prepared to be a sister to every Girl Scout, make an effort to get to know sister Girl Scouts in my unit and at camp, and find ways to be sure every participant is included in activities at camp.
    • We have reviewed the Girl Scout Promise and Law, and understand the behavior expectations for Girl Scouts at summer camp, including those behaviors which are taken very seriously, and may cause a camper to need to leave camp.
    • We have reviewed how to ask for help and support from camp staff, and when and who to tell if there is a problem. Problems might be getting along with another camper, not feeling well, missing family, or other situations where help or support is needed.
    • We have reviewed items which are prohibited at camp (cell phones, electronics, weapons, alcohol, drugs, tobacco, and pets) and will ensure none of these come to camp. By signing below, we promise to do our best to live by the Girl Scout Promise and Law at camp.
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