*To be completed by a parent or guardian only*
Knowing your child's burn history helps us provide the best camp experience possible for your child
Please list ANY allergies your camper may have: medications, food, insects, etc.
If your child requires an EpiPen, please provide it. Camp Janus is UNABLE to provide prescribed medications (such as EpiPens) for campers.
Please list ALL medications, dosages, and times the medication is given.
If your child has an EpiPen®, please send it with them to camp.
Please give the name and telephone number for the doctor who prescribed the medication. Please list EACH medication. Telephone information should be on the pharmacy bottle.
Please list any significant physical, cognitive, or behavioral conditions that may affect your child's experience at camp. This could be conditions such as Down Syndrome, ADHD, anger management issues, depression, heart conditions, broken bones, shunts, etc.
My child will travel to camp:
Parent or Guardian Information:
To be completed by a parent or guardian only
—To be filled out by parent or guardian only—
Please provide multiple names of emergency contacts. We will only notify the emergency contact if there is an emergency at camp and YOU ARE NOT AVAILABLE.
How you discovered Camp Janus:
Thank you for submitting your application for Camp Janus. We have received your application and will email you with check in details.
Please check us out on instagram @campjanus
or on facebook: CampJanus