Youth Education Additional Participant Information

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Please use this form to share any information that can help Youth Education provide the best experience for child(s).

Helpful information to include:

Physical health or medical details
Mental or emotional health details
Behavioral details
Individual Education Plan details
Any other information you’d like to provide

Why do we ask for this information?

When you send your child to camp, you entrust us with their care. We take this responsibility seriously, but we are only as good as the information that we are given. Therefore, we ask that you work with us to provide detailed and accurate information so we can better prepare our team to create a positive and rewarding experience for your child.

When we don't know about a particular child's needs, we may not be able to respond to their behavior properly. The better prepared we are before camp, the better we can help your child be successful once they are here.

Note: If your student requires special accommodations, please contact the Youth Education office at 801-581-6984 well in advance. To get a better idea of what accommodations are available, please contact the Office of Equal Opportunity at 801-581-8365.

Student First Name

Student Last Name

--- One Student per Form ---

Please use this space to provide information that Youth Education should be aware of:

Parent/Guardian First Name

Parent/Guardian Last Name

Primary Phone Number

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Secondary Emergency Contact:

First Name

Last Name

Primary Phone Number

Participant has been advised to maintain health and accident insurance to cover the cost of treatment in the event of any injury or illness.

Participant's Insurance ID Number

Insurance Carrier

Insurance Carrier Phone

Insurance Carrier Address

Contact Information
Information collected in accordance with our Privacy Policy.