Forms

Medical Policies and Procedures: Required Medical Forms

The Doctor’s form. This is a one page form the doctor signs every year.  Once complete, you may mail in, fax, or upload the form to your account. Our camp accreditation requires campers to have documentation of a physical examination conducted by a licensed physician within two years prior to their stay at camp. While campers do not necessarily need a physical every year.  We do need to have a new form completed on  yearly basis.  We are not able to use a health form from a previous year.  Click here for a printable version of the form.  This form is not available as an online form because it needs the doctor’s signature. This form is required for both Day and Overnight campers

Click here to print a copy of this form

The Camper Health History Form. The camper’s parent or guardian must complete and sign this four page medical form within 6 months of their camper’s stay at camp. Please provide camp with a copy of both the front and back sides of your camper’s health insurance card. Please contact the camp office if anything on the form changes after you have sent it in. This form is required for both Day and Overnight campers

Please mail, fax, or upload your completed medical forms to camp as soon as possible.  All forms are due by May 11.  Please retain a copy to bring to check. We cannot allow any camper to remain at camp without a current and complete health forms. These medical forms include documentation of parental consent, allowing the camp staff to provide emergency medical attention for a camper if necessary, and basic health insurance information to be used if the camper requires medical care or prescription medication.

Click here to fill this form out online.

The Camper Information Form

Rainbow over the Skipper Shack

This form is filled out annually by both the parent and camper.  The parent side gives our staff helpful information about the camper such as fears or strengths. The info will not be seen by your child and will only be seen by the staff working with your child and used to insure that he can get the most out of his camp experience.

The camper side allows our staff to get to know the camper before they arrive at camp.  We use this information to help place campers in cabins and to better prepare for their stay at camp.

This form can be filled out online by the campers and families or by paper and sent to camp. This form is required for both Day and Overnight campers.

There is a camper section and a parent section

Click here to fill out the camper section online

Click here to fill out the parent section online

The Family Confidential form

This form is filled out annually by the parent or guardian. As a non profit we rely on United Way allocations, public funds, private foundations, and individual contributions to support scholarships and programs. It is our goal that every boy be give the chance to attend camp. We ask that you help us educate our community about the people involved in our programs by completing this form. Your answers will be kept anonymous and confidential. This form is required for both Day and Overnight campers.

Click here to fill this form out online

Transportation Forms

Overnight Camp

This form if filled out annually by the parent or guardian to indicate how a camper is arriving and departing from camp.  If arriving by plane, bus or train, this form allows you to give us arrival and departure information.  The transportation form also allows parent/guardians to give permission for others to pick up or drop off their child(ren).

Click here to fill this short form out online

Day campers fill out their transportation options on the day camp registration form.

Please click here to contact the camp office if you would like us to send you a paper copy of any forms.



GREATER BURLINGTON YMCA LOCATIONS

Pomerleau Family Y
266 College Street
Burlington, VT 05401
802 862 9622 (YMCA)

Y Annex
298 College Street
Burlington, VT 05401
802 862 9622 (YMCA)

Camp Abnaki
1252 Abnaki Road
North Hero, VT
802 372 9622 (YMCA)

Additional Program Sites
in Vermont

Addison, Franklin, Grand Isle, Washington and Chittenden Counties