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Tell Us About Your Bouncing Bear

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Tell Us About Your Bouncing Bear

From the parent of:full name

Is this your childs first camp experience?

YesNo

Has your child attended a preschool program?

YesNo

Has your child attended a daycare program?

YesNo

What tips can we use to encourage, help and care for your child?

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All campers are required to be bathroom independent (“potty-trained”). This can be a challenge when having fun at camp. We will offer frequent bathroom breaks. Are there any words/cues we should be aware of if your child has to go or use to encourage them to “try” when we are all taking a trip to the bathroom?

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What comforts your child when they are hurt or anxious about something?

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Since registration, are there any medical issues or emotional/behavioral issues that you feel we should be aware of?

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Are there any worries or concerns your child has specific to Covid-19 and coming to camp that we should be aware of?

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Is there anything else you would like to share with us about your child?

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At camp this summer, my goal(s) for my child are:

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Please share with us information about your child’s swim experience. Do they enjoy the water, getting their face wet, have they had swim lessons, does swimming make them uncomfortable?

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Are there any concerns you have about camp swim lessons?

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Parents: Fill this out with your child; sharing with us your child’s perspective.

Dear Action Kids Camp Counselors:

My name is:your full name

My friends call me:more details

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I would describe myself?pick all that fit

quitenoisyshyoutgoingfunnyseriousobserveractiveartisticmusicalathleticceativeother

If your answer was other what would you like to add?your full name

The # 1 thing you should know about me is:more details

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Sometimes I am afraid of/or worry about:more details

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What I am looking forward to at campchoose as many as you would like

having fun learning something new making new friends outdoor gamesswimming gymnastics crafts nature wacky adventures being with my friends everything!

Tell us about of your favorite summertime activity!more details

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Parent/Guardian signature - this is considered an electronic signature

Your Email if you would like a copy of this form sent to you

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Brentwood Commons

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Contact Info

Action Kids at Brentwood Commons
112 Crawley Falls Road
Brentwood, NH, 03833

Phone: 603-642-7200

Fax: 603-642-921

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