Ramapo for Children > Summer Camp > Apply Now

		Early Adventure (4-6)
		Summer Adventure (7-14)
		Teen Leadership (14+)
		Professional Report

Summer Camp Video

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Teen Leadership (Ages 14 and Up)

Please rank the sessions in order of preference
Session 1:
Session 2:
Session 3:

Camper Information:

First Name:

MI:

Last Name:

Sex:

MaleFemale

Birthdate:

Age on June 1, 2006

Parent/Guardian Name:

Address:

Apt #:

City:

State:

Zip:

(The above address will be used for all written communications.)

Home Phone:			Work Phone:
Cell Phone:			E-Mail:

How did you hear about Camp Ramapo:

Why do you want your child to attend Camp Ramapo rather than a regular camp?

What are your child's strengths, interests, and/or talents?

Briefly describe your child's education program:

How does your child get along in a structured school environment?

Please describe your child's problem behavior(s):

Under what circumstances does your child become stressed or frustrated?

Suggestions for successfully managing your child when s/he is frustrated:

Briefly describe counseling or therapy services the child receives:

Describe any physical characteristics which might affect your child’s participation in the program:

List all the members of camper’s household and describe any important issues of which we should be made aware:

Please check below the area with which you feel you child needs the most help:
Relationship Building Self Control Self Help Communication Attitude

Please describe a specific goal for your child in the area you choose:

Social Attitudes: Please select the letter in each area that best describes your child.

Relationship to other children:	A. Works and plays well with others B. Does not get along with others C. Prefers to be alone rather than being with others
Relationship to adults:	A. Friendly and cooperative B. Cooperative, but shy or withdrawn C. Uncooperative, appears not to listen or follow directions
Attitude toward social group: (with adult direction)	A. Responds well to group control B. Occasionally resents group control C. Usually non-conforming
Need for attention:	A. Satisfied with reasonable amount of attention B. Requires a great deal of attention
Temperament:	A. Usually even tempered B. Occasional temper outbursts C. Frequent temper outbursts
Group Participation:	A. Participates actively in group activities B. Participates when encouraged C. Shy, withdrawn, does not particpate
Self-Confidence:	A. Usually works with confidence B. Needs frequent encouragement C. Lacks confidence, needs constant encouragement
Activity level:	A. Usually passive B. Normally energetic C. Usually restless, hyperactive

Please rate your child's skill level in the following areas

Communication (asks questions, starts conversations, expresses feelings, asks for help, etc.):	Excellent Good Fair Poor
Motor (jumps, runs, draws recognizable pictures, etc.):	Excellent Good Fair Poor
Self Help (dresses self, brushes teeth, washes self, etc.):	Excellent Good Fair Poor
Relationship Building (asks other children to play, expresses concern for others, apologizes when appropriate, etc.):	Excellent Good Fair Poor
Responsible Behaviors (stays away from dangerous situations, respects others' space and privacy, follows directions, etc.):	Excellent Good Fair Poor
Attitude and Adjustment (likes to try new things, tries again - even when frustrated, etc.):	Excellent Good Fair Poor

Which of the following activities/times of day might be difficult for your child at Camp?
(Please check as many as you would like.)

Wake up
Helping to clean up his/her area in the cabin
Meals (eaten family style)
Small Group Instruction
Crafts activities
Nature/woods activites
Athletics activities
Group games
Moving from one activity to the next
Showering
Bedtime

Briefly explain your reason(s) for checking the above items?

Please provide any other information you feel is important for us to know.