Camper Name
Camp Session/Dates
Parent/Guardian Name
Email Address
Phone Number
Please rate the following on a scale of 1 to 5 (1 = Poor, 5 = Excellent)
Category | Rating | |
|---|---|---|
Quality of Activities | ||
Safety and Supervision | ||
Food and Nutrition | ||
Staff Friendliness/Helpfulness | ||
Overall Camp Experience |
This section is crucial for our medical team to ensure all health requirements were met during your child's stay.
Please list the medications your child was scheduled to receive:
Medication Name | Prescribed Dosage (e.g., 10mg) | Frequency/Time (e.g., 2x daily, Morning) | Was this administered correctly? | ||
|---|---|---|---|---|---|
1 | |||||
2 | |||||
3 | |||||
4 | |||||
5 |
How would you rate the communication from the camp medical team?
Excellent
Satisfactory
Needs Improvement
Did you feel your child’s health needs/allergies were taken seriously?
Yes
No
N/A
Comments on Medical Care: (Space for notes regarding any specific health incidents or administration concerns)
Who was your child’s primary counselor?
Did the staff help your child feel included and safe?
Always
Mostly
Sometimes
Never
What is one thing a staff member did that made a positive impact?
What was the highlight of the camp for your child?
What is one area where the camp could improve for next year?
Would you recommend this camp to other families?
Yes
No
Maybe
Parent/Guardian Signature
Form Template Insights
Please remove this form template insights section before publishing.
This form serves as a vital bridge between the camp's operational activities and the family's expectations. By looking deeper than just "stars and ratings," the form provides a roadmap for excellence in care and programming.
The most significant insight this form provides is a verification loop for medical care. By asking parents to list specific doses and frequencies, the camp can perform a "blind match" against their own medical logs.
The section regarding Staff and Counselor Evaluation provides a direct look into the "human element" of the camp.
The Safety and Supervision rating acts as a barometer for the camp’s environment.
Feedback on Food and Nutrition is more than just about taste; it’s about fuel.
The Open-Ended Feedback section provides qualitative data that numbers cannot capture.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation before publishing.
In the Summer Camp Experience & Health Feedback Form, the following questions are considered mandatory. These ensure the integrity of your data and the safety of the campers for future sessions.