Camp Buddy Registration "*" indicates required fields Camp Buddy Options* Effingham (June 8 - 12) -- $30 Chatham (June 22 - 26) -- $30 Both Camps -- $60 Camper's Name* First Last Parent's Name* First Last Parent's Phone #*Parent's Email* Secondary Contact for Camp Week*Enter Name and Phone NumberName of Person Picking Up/Dropping Off*Camper's AgeCamper's Last Grade CompletedCamper's T-Shirt SizeCXSCSCMCLAXSASAMALAXLA2XLA3XLTypical Dietnote any issues with eating, i.e. food aversions, dietary restrictions, etc.Allergies (include food and other)If none, enter 'none'Primary Method of Communication* Verbal - communicates effectively with spoken language Gestures - communicates mostly by pointing or showing Nonverbal - communicates displeasure/pleasure with actions/expressions Sign Language AAC Device If AAC Device, what kind?Adaptive Equipmenti.e. utensils, orthotics, slant board, scissors, etc.Bathroom Needs* Potty Trained - will ask to use Potty Trained - needs prompting Pullup/Diaper - needs assistance Other If Other, please explainBehaviors to be Aware ofIf none, enter 'none'Has your child been checked for Atlantoaxial instability?*Other Medical NeedsPlease include any medications that need to be given at Camp Buddy. If none, enter 'none'.What interests and motivates your child?*If this is your child’s first time at Camp Buddy, please send a copy of your child’s IEP goals and objectives with a copy of specific modifications to cbogardus@ldssga.org.Total Payment Method*PayPal CheckoutCredit Card American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
