Name
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Date of Diagnosis
*
Approximate
MM
DD
YYYY
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
T-shirt Size
*
Small
Medium
Large
Extra Large
2XL
3XL
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
(###)
###
####
Emergency Contact Email
*
May we photograph and/or videotape you for educational purposes?
*
Yes
No
All campers must be able to independently perform all self-care tasks. These include: Eating, dressing, showering, using the restroom, transferring in/out of vehicles. Campers understand that Mr Oscar Monkey staff do not have the proper training to assist in such tasks. Mr Oscar Monkey staff works hard to accommodate all campers and their needs, which arise during the camp week. With this in mind, activities are carefully selected to provide a safe, respectful, and supportive environment for all campers, staff, and volunteers. If a camper is unable to meet these self care and mobility requirements, they will be asked to bring a Personal Care Attendant, at the camper’s expense.
*
Yes
No
No bullying of any kind will be tolerated. Each participant and staff will be treated with courtesy and respect.
*
I agree
Smoking, vaping, and illegal substances will NOT be permitted at any time during CYAMS
*
I agree
It is your personal choice to attend CYAMS
*
I agree
All participants are between the ages of 19 and 25 years old
*
I agree
No outside visitors are permitted without prior approval
*
I agree
No underage drinking will be tolerated
*
I agree
Any alcohol consumption will be done so responsibly and respectfully
*
I agree
