SPARK Registration Form

Camper Name *

First

Last

Contact Email *

Birthday *

Camper Age Group *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Choose which week(s) you would like to attend camp

Emergency Contact Information

Main Contact *

First

Last

Relationship to Camper

Main Contact Phone Number *

Secondary Contact *

First

Last

Relationship to Camper

Secondary Contact Phone Number *

Camper Information

Does your camper require 1-1 support (our ratio otherwise is 3-1) *

Yes
No
Not Sure

Has the camper been to any Sonshine Program within the past year? *

Yes
No

Does the camper have any known allergies? *

Yes
No

year? Does Number

Please list all allergies and their severity. Does your camper have an EpiPen? *

Check all that apply *

Other: *

Does your camper use any of the following medical devices? Check all that apply *

Other: *

Is there any other medical information or present treatments we should be aware of (recent medical procedures, illnesses, rashes, etc)?

Behaviour Support Information

Does your camper experience any difficulty in social settings? *

Yes
No

If yes please explain. How do you recommend we respond? *

Please list potential problems for your child (i.e. fears, wandering, jealousy etc.) *

Does your camper exhibit any of the following behaviours? *

Explain what these behaviours look like for your camper and how your recommend we respond *

What typically triggers these behaviours? *

Does your camper have any history of inappropriate behaviour towards others? *

Personal Care

Describe the support your child needs in toileting/ changing. Does your camper wear diapers or other personal care items? *

Does your camper take medication of any kind between the hours of 9am-3pm? *

Yes
No

Describe the guidence/ assistance your camper needs at meal & snack times *

Can your camper sit at the table with their peers? *

Yes
No
Yes, only with a staff seated next to them

Will your camper steal food or drinks from other staff, campers or from other tables? *

Yes
No

Transportation

Can your camper sit independently? *

Yes
No

Can your camper sit next to and behind other participants in a vehicle? *

Yes
No

Does your camper require assistance or restraints (harness, seatbelt clip, adapted seat)? *

Yes
No

If yes, please explain

Additional Support Information

What level of support does your camper receive at school or day program? *

Please include any additional information that would be helpful to the camp staff to create a positive camp experience? *

Please provide a photo of your camper for their profile *

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