Washington County All Abilities Camp

June 17-20, 2024

Attendee Age Range*

Payment Option*

Coupon Code

Sub-Total

$0.00

Camper Name*

Camper Address*

Camper Age At Time of Camp*

Camper Date of Birth*

Camper Home Phone Number*

Camper Cell Phone Number

Subscribe to FCA text messages

I would like to receive occasional text messages from FCA about future resources and programs.

Camper Email*

Subscribe to the Daily Impact Play email

I would like to receive the Daily Impact Play email, spiritual training for coaches and athletes of all levels.

Camper Gender*

Camper School*

Grade In Fall*

T-Shirt Size (Sizes Run Small)*

Activity*

Name of camper's disability:*

Please describe how this disability manifests:*

Sports/fitness activities in which the camper has already participated or is currently participating*

What do you need us to know and understand about this camper?*

Does this camper have any triggers?*

Are there any activities that can calm this camper if he or she is feeling overwhelmed?*

Choose the best that applies. The camper would best learn:*

In a typical setting for the camper’s age group with no supports
In a typical setting for the child’s age group with a buddy who is:
- An adult - An older student - A peer
In a separate area with a trained teacher and a small group of other special needs students
A combination of the above. Please describe why you believe this to be your camper's best learning setting selection

Does your camper suffer from seizures?*

What other medical concerns should we know about?*