Open Camps

GLOW Kids Camp

Initial Referral

Referring Agency

Contact First Name

Contact Last Name

Contact Email

Contact Phone

Child's Details

Child's Name

Gender (optional)

Date of Birth

Open Camps accepts referrals for children aged between six and ten years old, based on the child's age at the time of the camp. Children cease to be eligible after their eleventh birthday.

Support Needs

Please indicate areas where the child may need support, where 1 means little to no support and 5 means ongoing, constant support.

Managing Conflict

Sensory Overload

Self-Regulation

Participation

Personal Space

Following Instructions

Open Camps' programs are about providing a respite opportunity to young people who would otherwise miss out. Please provide some details of the child's background, home life, or school life, that will help us to assess their suitability for the program.

Why is the GLOW Kids Camp the right experience for this child - what do you hope they will gain from attending?

Are there any warning signs or triggers our volunteers should be mindful of when working with this child? (optional)

Thank You!

Successful applicants will be notified as soon as possible. A separate consent form will then be issued for completion prior to camp. The consent form must be completed in full and returned with medical records for the child's place to be secured on the camp.