This confidential resume is a valuable tool which will assist us in enhancing your child’s summer experience. If deemed in the best interest of your camper, information may be confidentially shared with senior staff members. Please submit one form per camper. Thank you!


Camper's First Name:
Middle Initial:
Last Name:
DOB:
Current School:
Current Grade:
Home Phone #:

Family Ties

List all siblings attending SSDC:
List other relatives attending SSDC:
List primary household family members (If second residence, please elaborate):
Please advise us of any issues or conditions which may affect your child’s summer (i.e. health of a family member, new baby at home, parent’s separation, custody issues, new residence, etc.)

Physical & Emotional Health and Welfare

Are there any physical, emotional or behavioral issues about which we should be aware?: Yes No
If "Yes" please specify:

Are any outside agencies or professionals involved in your child’s development?:

Yes No
If "Yes" please specify:

Are there any allergies or other medical conditions about which we should be aware?:

Yes No
If "Yes" please specify:



Camper’s Interests

Favorite camp activities:

Please share any concerns about any specific camp activities:

Please share your thoughts on how we can best enhance your child’s experience at SSDC:

Email Address: (required)

Additional Comments and/or Information:
Please enter the number you see here:   (required)


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