Animal Rescue League of NH · Camp Critter Humane Education Camp Registration

Camper Attendance Qualifications

Thanks to a generous grant from The Latham Foundation, the Camp Critter Humane Education Camp is able to provide full scholarships as funds allow for the children (ages 6-13) of military and first responder families in the Greater Manchester, NH area. To qualify, your child must reside at least part-time in a household with a family member who is a veteran, active military, or first responder.

If your child does not qualify for camp this year, please check back next year as we hope to be able to expand our offerings to additional families.

My child resides at least part-time in a household with a family member who is a veteran, active military, or first responder?

*

Yes

Military, Veteran, or First Responder Verification

Please submit one form of documentation verifying the family member's status as a military member, veteran, or first responder. ARLNH will accept numerous forms of verification based on organization and status. Examples of documentation can include: An employee/volunteer ID card, military ID card, paystub less than 60 days old, letter from employer, etc.

Verification File Upload

If you are having trouble submitting a file via the form, please email the documentation to campcritter@rescueleague.org

Camper Information

Name

*

First Name

Last Name

Gender

*

Male

Female

Other

Birthdate

*

(mm/dd/yyyy)

Grade Entering in the Fall

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

T-Shirt Size

*

Campers will receive one t-shirt with their camp registration.

T-Shirt Size Chart

Camp T-shirt Size Chart.png

Session Registration

Session Dates

*

Please choose camp session based on your child's current age.

Parent/Guardian Contact Information

Parent/Guardian #1 Name

*

First Name

Last Name

Relationship to Child

*

Email

*

Verify Email

*

Phone

*

Mailing Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Parent/Guardian #2 Name

First Name

Last Name

Relationship to Child

Email

Verify Email

Phone

Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Confidentiality Statement

Information regarding your child's emergency, medical, mental, emotional, and social history is gathered to help ensure a positive camp experience. This confidential information is kept in a secure location that is only accessible to camp staff and the Animal Rescue League of New Hampshire's Leadership Team.

Emergency Information

If parents/guardians cannot be reached.

Name of Emergency Contact

*

First Name

Last Name

Relationship to Child

*

Phone

*

Health Care Provider

*

Name of Practice

*

Phone

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Insurance Carrier/Plan Name

*

Policy #

*

Subscriber Name

*

Subscriber Relationship to Camper

*

Health Information

Gender Identity

*

Height

*

Weight

*

Medical History

Medical History: Please check Yes or No for each question below.

Explain "Yes" answers in the space provided below.

Have Asthma?

*

Yes

No

Have diabetes?

*

Yes

No

Have seizures or seizure disorder?

*

Yes

No

Other recurrent/chronic illness?

*

Yes

No

Been hospitalized/had surgery in past two years?

*

Yes

No

Ever had head injury or concussion?

*

Yes

No

Had severe or frequent headaches?

*

Yes

No

Have stomach or intestinal issues?

*

Yes

No

Passed out/had chest pain during exercise?

*

Yes

No

Had fainting or dizziness?

*

Yes

No

Have frequent bloody nose?

*

Yes

No

Ever had back/joint problems?

*

Yes

No

Ever been stung by a bee?

*

Yes

No

Have any skin problems?

*

Yes

No

If 'Yes' Explain:

Mental, Emotional, and Social History

Mental, Emotional, and Social History: Please check Yes or No for each question below.

Explain "Yes" answers in the space provided below.

Ever been treated for ADHD?

*

Yes

No

Have a phobia?

*

Yes

No

Ever been treated for emotional/behavioral difficulties?

*

Yes

No

Ever have a need for an aide at school?

*

Yes

No

During the past year, seen a professional to address mental/emotional heath concerns?

*

Yes

No

Used an individual education plan (IEP) during school year?

*

Yes

No

Have a significant life event that continues to affect camper's life?

*

Yes

No

If 'Yes' Explain:

Allergy History

Allergy History: Please check Yes or No for each question below.

Explain "Yes" answers in the space provided below.

Allergies?

*

Yes

No

Food?

*

Yes

No

Drug?

*

Yes

No

Environmental?

*

Yes

No

If 'Yes' Explain:

Risk of anaphylaxis? What is emergency allergy plan?

Restrictions

Restrictions: Please check Yes or No for each question below.

Explain "Yes" answers in the space provided below.

Any activity restrictions?

*

Yes

No

If 'Yes' Explain:

Medications

The Animal Rescue League of NH Staff are not permitted to administer medication to children. Campers should take medications before arrival.

If your child needs to take medication while at camp, even an over-the-counter medication such as an antihistamine, you will need to provide a doctor’s prescription listing the medication, dosage amount, and dosage frequency. We will also need a signed permission slip from the parent/guardian for staff to supervise the camper's self-administered use of medications. Sunscreen and bug spray must be provided by the parent/guardian.

Campers that require epinephrine/EpiPens and/or asthma inhalers will need to keep these items in their possession. Please label EpiPens and/or inhalers with the camper’s full name.

Medications at Camp:

*

I acknowledge that my child's required medication(s) are to be taken before arriving at camp.

I acknowledge that any self-administered over-the-counter medication requires a doctor's note.

Emergency Medications

Emergency Medications: Please check Yes or No for each question below.

Explain "Yes" answers in the space provided below.

Does your child require a rescue inhaler and will be bringing it to camp?

*

Yes

No

Does your child require an EpiPen and will be bringing it to camp?

*

Yes

No

Can your child self-administer their emergency medication(s)?

*

Yes

No

Please keep an eye on your email inbox for an email with a welcome packet confirming your child's acceptance into summer camp. Staff will be reviewing all registrations manually. Thank you for your patience.

Please visit www.rescueleague.org/campcritter or email campcritter@rescueleague.org with any camp-related questions or concerns. Thank you for your interest in Camp Critter!