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Why NJY Camps
About Us
Mission, Vision & Values
Our Leadership
Giving Opportunities
NJY In The News
Our Blog
Round Lake Inclusion Program
Retreat Center
Family Camp Weekends
International Campers
Total Specialty Camps
Our Locations
About Us
Our Camps
Alumni
Alumni Overview
Alumni Funds
Events
Share Your Story
Join the Alumni Association
L’Dor V’Dor – Monthly Giving Society
Alumni Overview
Join our Team
The Staff Experience
Year Round Openings
Summer Staff Application
Certification Courses
The Staff Experience
Login
2025 Intakes
2025 New Camper Intake Form
Camper Name
*
First
Last
Name of Parents/Guardian on the phone
*
First
Last
Camp
*
NJW
CLC
Session Registered for 2025
*
1st Session
2nd Session
Full Summer
1st Session – 2 Weeks
2nd Session – 2 Weeks
1st Session + 2 Weeks (6 Weeks)
Grade Entering Sept 2025
*
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
Interviewer
Interviewer
*
Sam Kahn
Caroline Kramer
Amanda Kramer
Kelsey Kilduff
Eli Klein
Rachel S
Jeff H
Shira Roth
Justin Grosman
Matt Montello
Wendy W
Owen E
Syd Bladen
Kayla Roth
Heidi Masuri
Matt Waldman
Jake Weissberg
Eva Tell
Other
General Questions
How did your child do this past school year?
Has your child attended a camp before:
Yes
No
Day camp or residential camp?
Day
Residential
Which camp and please describe their experience?
Has your child expressed any feelings about attending camp this summer?(examples of feelings: Excitement, Apprehensive, Nervous, Worried, Scared, and Ambivalent)
How does your child react to new situations?
Well
Initially Shy
Fearfully
Aggressively
Negatively
Cautiously
Other
What role does your child take in his/her social relationships?
Leader
Follower
Compromiser
Passive
Aggressive
Bossy
Scapegoat
Other
Please describe how your child behaves when they are upset.
Is your child able to clearly identify and talk about their feelings?
Yes
No
It Depends
How do they deal with their feelings? (Are they more comfortable speaking with peers or adults)
Does your child have any sleeping issues?
Yes
No
Please list issues and reasons
Does your child have any eating concerns we should be aware of?
Yes
No
Please list concerns and reasons
What would you like your child to get out of their experience at Camp?
Family Dynamics Questions
Please share with us who resides in your household
Any Pets?
Any recent/past changes to your family dynamics we should know about?
Yes
No
Deaths/Moving/Divorce
Please share with us the details and how your child is adjusting:
Medical Questions
1. Remind parents to complete all health forms in their CampMinder account to ensure we have the most up to date medical information on their child.
2. If the child takes medication, please also be sure to discuss with parent HOW our daily medications are distributed.
3. Breakfast/Lunch/Dinner Meds/Night time (4 specific times), if parents need a special time please tell them to make the camp director aware of the special timing. For example: Mid-afternoon 3 or 4pm medication time
4. Please let them know that campers line up at meals/before or after meals to receive their medications, they line up with all the campers who take meds at that time which means they do wait in line. If parents feel they don’t want their child waiting in line, please indicate that in notes for follow up. Please do not tell parents they have no choice. Camp director can make suggestions on how to proceed.
5. If parent makes comments about taking children off meds for the summer, please make a note in “Interviewers notes” for director to follow up
Does your child have any allergies?
Yes
No
If yes allergies, please list.
Confirmed with Parent to include this in CampMinder
Yes
No
Are allergies anaphylactic?
Yes
No
Confirmed with Parent to include this in CampMinder
Yes
No
Will you be supplying your child with Epipen?
Yes
No
Confirmed with Parent to include this in CampMinder
Yes
No
If your child has a food allergy how aware are they of the allergy?
Is your child Gluten Free?
Yes
No
If yes, indicate
Celiac
Allergy
Intolerance
Confirmed with Parent to include this in CampMinder
Yes
No
Does your child take medications on a daily basis?
Yes
No
Confirmed with Parent to include this in CampMinder
Yes
No
Please list any other medical concern/chronic medical issues we should be aware of:
Confirmed with Parent to include this in CampMinder
Yes
No
Is your child currently in any form of therapy?
Yes
No
If yes, please share with us why.
Does your child receive any special support/accommodations in their school setting?
Yes
No
If yes, please list supports/accommodations they receive (speech, occupational therapy, or social supports)
Questions for the enrolled Camper (to be answered by child)
CAMPER QUESTIONS
What activities do you enjoy doing? Please list any hobbies/teams/etc.
What activities are you looking forward to doing the most camp (feel free to give them examples)?
Whose idea was it to attend camp?
Mine
Parents
Friend
Other
Have you ever slept away from your family before?
Yes
No
If yes, please tell us where and for how long.
How do you feel about going to camp this summer?
Are you worried or nervous about going to camp this summer?
Yes
No
Do you find it easy to make friends?
If yes, can you identify anything specific you are worried about?
Bunking
(must be in the same grade and reciprocal )
Bunking Request – Choice 1
Bunking Request – Choice 2
Bunk-Bed Request Notes – Top, bottom etc
Potential New Campers
Ask parents about friends to contact
Do you know someone who may want to attend NJY Camps?
Camper’s Name
Who should we contact?
Parent’s Name
What do you think they may be interested in?
Camp for This Summer
Camp for Next Summer
First Step
Family Camp
Camp Tour
Approximate Age of the Potential Camper:
Email (Contact person for new camper):
Phone (Contact person for new camper):
Summary / Extra Notes
Interviewers Notes for director/division head:
•
Forms
–
All forms need to be completed in CampMinder.
•
Bunking
–
a bunking form can be found on your campers NJYHome account. You are allowed to request 2 people on the request form. If you would like your child to be bunked with new campers, there is an option where you can choose “bunk with new campers” or “no requests at this time.” NJY Camps typically bunk campers by what grade they are entering into, by how long they are coming to camp and by using their bunk request form. If parents request a bottom/top bunk please tell them they can use one of the 2 requests they are provided to type in “Bottom or Top.” If all requests do not fit on the form please email the director.
• Direct parents to purchase the “required camper package” by going to the www.thecampspot.com
• Packing list will be on NJYHome under “forms.” If they ask for suggestions please feel free to provide reasonable suggestions (rain boots, shower caddy, battery operated fan, etc)
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