Annual Camper Information and Medical Form

2022 Annual Camper Information and Medical Form

This form must be completed in order to process Curiosity Camp registrations. Camper information will be kept on file and only needs to be submitted once per calendar year.
Camper Info
Camper - Full Name *
Camper - Date of birth *

Month Day Year
Date
Camper - Age *
Camper - T-shirt size *
Note: Mini-campers do not receive T-shirts
Camp is more fun with a friend! Many camps are divided into multiple groups. If your camper is attending with a friend, please list the friend’s name here to request that they be placed in the same group. Siblings with the same last name are always placed in the same group unless you request otherwise. Additional requests can be sent to camps@rmsc.org.
Camper - Friend request
Friend request
Medical Info
Does your child have any of the following: *

none Food/Medication Allergies Insect Sting Allergies Asthma Diabetes Seizure Disorder
For allergies, please specify:
My camper will be bringing and/or taking medication (including EpiPens and inhalers) while at camp *
If YES, please specify:
Medication must be brought in its original container and accompanied by a completed Medication Form from the camper’s caregiver including the following
Disabilities and Extra Support

Curiosity Camps strives to provide an accessible and safe environment for all campers. If your camper has a disability or needs extra support, please use this space to provide details on how we can assist your child in having the best possible experience with us.

Please note: RMSC Curiosity Camps cannot provide 1:1 aides. Campers will be in groups of approximately 20 campers, with a staff to camper ratio of approximately 1:5. If your camper has a 1:1 aide or receives special services during the school year, please contact Camp Administration before registering for more information about the structure of our camp program.
Does your child have any disabilities or need any extra support? *
If YES, please specify:
Personal Info
Caregiver Name *
Name
Relationship to Camper *
Relationship
Address *

Address

Street Address Line 2

City State

Zip
Phone *
Email *
example@example.com
Caregiver Information
Additional Parents/Caregivers/Emergency Contacts *
We are always looking for volunteers, guest speakers, and local experts to share their knowledge and experience with our campers. If you’re interested in working with us, please share your occupation and any other information here:
Caregiver Agreement & Expectations

By registering this camper, you are giving permission for your camper to participate in the Rochester Museum & Science Center’s camp program and agree to the following items:
Note: Submitting this form does not register your child for camp. Please visit www.rmsc.org for camp selection and registration. If you arrived at this form from the camp registration page, please be sure to return to that page to complete your registration and payment.
Should be Empty:

Camper Info

Medical Info

Personal Info

Caregiver Information

Caregiver Agreement & Expectations