Get Wagon Road Camp

This guide provides comprehensive instructions for completing the Wagon Road Camp application form online. It is designed to assist parents and guardians in ensuring that all required information is accurately filled out for their child's participation in the Overnight Respite Program.

Follow the steps to successfully complete the Wagon Road Camp application form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the camper's information, including their last name, first name, home address, and date of birth. Be sure to accurately fill in the gender and disability fields.
3. Complete the demographic information section, which is optional. If applicable, indicate ethnic and racial background. This helps in reporting and planning activities.
4. Provide details about the parent or guardian, including names, addresses (if different from the camper), and contact information. Ensure that relationship to the camper is clearly stated.
5. List emergency contacts outside of your home, detailing their full names and contact numbers. Specify if they are authorized to pick up your child.
6. Fill in any Medicaid information required, including the agency’s name, coordinator’s details, and Medicaid number.
7. Read and sign the certification and consent statement for program admission, medical and dental consent. Be sure to provide the date and signature.
8. Complete the medication administration section if your child takes any medications, including providing the necessary doctor's orders on the Medication Authorization Form.
9. Detail any specific needs your child may have in the consumer care section. This covers behaviors, self-care/hygiene, eating, sleeping habits, and any other relevant information.
10. Review all information for accuracy. Once complete, save changes, download, print, or share the form as needed.

Complete the Wagon Road Camp application form online today to secure your child's spot in the Overnight Respite Program!