Day Camp Intake Form

Please complete this intake form for Lions Camp Horizon day camp. If you have questions before submitting, email acd@lionscamphorizon.org.

Parent/Caregiver Information

How did you find out about our day camp program? *

Camper Information

Has the camper previously attended the Lions Camp Horizon summer camp program? *

Day Camp Questions

What form of payment will be used? *
Who will be responsible for bringing the camper to and from the day camp program? *
How frequently do you want the camper to attend the day camp program? Please note that this will not commit you to a certain number of sessions. *
Please confirm you understand that day camp drop-off is at 9:00AM and all campers should arrive within 15 minutes of that time. *
Please confirm you understand that day camp pick-up is at 4:00PM and all campers should be picked up within 15 minutes of that time. *
What core curriculum areas are you and the camper interested in exploring at our day camp program? *

Camper Care Needs

Does the camper need a 1:1 or 2:1 camper to staff ratio for adequate care? This ratio may be adjusted after the camper attends a trial session. *
Does the camper exhibit any challenging behaviors such as running away, throwing objects, verbal aggression, physical aggression, etc.? *
Will the camper need to take medication or receive routine treatment during day camp hours, not including emergency response medications such as an epi-pen or inhaler? *

Personal Growth Plan Questions