2026 ACA Camp Paperwork Form

INSTRUCTIONS

Please fill out ONE form for EACH camper. An updated camp form is required every calendar year to cover a camper's participation in any ACA camp program.

Please have the following information readily available as this form does not allow you to save and return before submitting. We estimate this form will take approximately 30 minutes to complete. You can save your progress and return to the form as needed.

- allergy information including Anaphylaxis Emergency Care Plan documents

- the phone number and address for your camper's primary care physician

- emergency contact information

- the most recent copy of your camper's immunization record

- IEP or 504 if relevant

Links to additional forms that you may need:

-- Required Camp Immunizations

-- Food Allergy & Anaphylaxis Emergency Care Plan (this will need to be signed by a physician if you do not already have a version of this)

-- Authorization to Administer Medication

CHILD INFO

Camper's Legal Name (First)

Camper's Legal Name (Last)

Camper's Preferred name

Date of Birth

School

Grade in Fall 2025

Gender

Pronouns

Eye color

Hair color

Height

Weight

Identifying Marks

Primary Language

Secondary language

Camper's Home Address Line 1

Address Line 2

City

State

Country

Postal Code

2026 CAMP OFFERINGS

February & April 2026 Vacation Camp Offerings: Please select all weeks your camper is registered for: Vacation Arts Camp (Gr K-5), Art Academy (Gr 3-6) or Teen Studios

February Vacation Camp (2/16-2/20/26): Vacation Arts Camp, Art Academy, Teen StudiosApril Vacation Camp (4/20-4/24/26): Vacation Arts Camp, Teen Studios

EMERGENCY CONTACTS / AUTHORIZED PICK-UPS

NOTE: We strongly encourage you to list people other than the parents/guardians listed above.

ACA ID Policy

ACA staff will cross-check our Authorized Pick-Up list and the ID of the person picking up each day of camp. We thank you in advance for helping us keep all of our campers safe. Please be prepared with ID- if you don’t have ID we will ask you to go get it so we can be consistent with the practice for all camp families. While this may be an inconvenience for some families, for others it provides peace of mind.

Please Note: We can only dismiss campers to those listed as “Authorized Pick-Up” on their camp form. This includes family members, family friends, and babysitters. Please understand that this protocol is in place to ensure the safety of all campers. Families can ask for ACA staff to modify their Authorized Pick-Up List via email in order to provide written documentation. All individuals listed as “Authorized Pick-Up” are still required to show their ID when getting a camper from camp.

Emergency Contact Information #1

First Name

Last Name

Phone Number

Relationship to child

Permission for child to be released to this person?

YesNo

Emergency Contact Information #2

First Name

Last Name

Phone Number

Relationship to child

Permission for child to be released to this person?

YesNo

Emergency Contact Information #3

First Name

Last Name

Phone Number

Relationship to child

Permission for child to be released to this person?

YesNo

Please use the section below to write the full legal first & last name(s) of any additional persons authorized to pick-up your child from ACA camp.

CAMPER SELF-DISMISSAL

- If a camper will be arriving late without an adult, you MUST notify ACA staff via phone call/email.

- If your camper needs to leave camp programming EARLY and self dismiss (ie: for an appointment), you MUST notify ACA staff via email 48 hours in advance.

Campers who need to leave camp due to illness will NOT be allowed to leave without an approved adult due to safety concerns.

Would you like to give permission for your camper to arrive at camp AND/OR leave ACA camp at the end of programming without needing an adult present to sign them in/out?

YES, I give my camper permission to CHECK THEMSELVES IN AND OUT of camp WITHOUT an adult.NO, please require an authorized adult to pickup my camper. My camper will NOT check themselves in and out of camp.

LEARNING & BEHAVIORAL INFORMATION

We want to support our campers and ensure they have a positive camp experience. In order to do this, we ask caregivers to be transparent about any learning or behavioral support your camper may need. This allows our team to proactively create a safe environment for campers and staff.

Please be transparent about anything our camp staff should know about your child.

This may include neurodivergence, personality quirks, life transitions like family changes or moving, environmental or conversation topic sensitivities (ie. "my camper does not enjoy talking about dogs and is scared of loud noises"), or triggers for dysregulation.

Please reach out to campmanager@acarts.org if these conditions change at any time. We encourage open and consistent communication.

We encourage you to use the section below to share any tools, models or support systems utilized at school, activities or home so we can continue to support your camper through their time at camp.

Do you have any additional documentation you would like to share about your child and how we can best try to serve their learning/behavioral needs?

YesNo

Upload any additional documentation here.

Friend Requests: If you would like to facilitate a friend request, please list only one other camper you would like your child placed with (First and Last name please).

IMMUNIZATION FORM (REQUIRED)

View your camper's immunization requirements here.

ACA requires a copy of our campers' latest immunization records. If you have an electronic copy, upload it below. Or send it to us by mail at 20 Academy St in Arlington, MA 02476. We also accept photos and copies via email at campmanager@acarts.org.

YOUR CAMPER WILL NOT BE ABLE TO JOIN US AT CAMP WITHOUT A COMPLETE IMMUNIZATION RECORD ON FILE.

Please upload your Immunization Form below.

PARENT/GUARDIAN ATTESTION

Based on current guidance from the Town of Arlington Board of Health, CDC, and the
Massachusetts Department of Public Health, Arlington Center for the Arts (ACA) does not require proof of COVID vaccinations or masks for participation in our programs, including classes, camps, exhibits, performances, and events. ACA’s top priority remains the health and safety of our community. We continue to monitor developments related to COVID, following guidelines and recommendations from the Town of Arlington Board of Health, Massachusetts Department of Public Health, and the CDC and will update policies accordingly. For more information about COVID, please visit: www.cdc.gov/covid

Please contact our staff directly at info@acarts.org if you have any questions or concerns.

Acknowledgements

By typing MY NAME below, I attest that I have read, understand, and will comply with the listed conditions.

I acknowledge and attest to the above COVID policy above (Please type your full name below)

MEDIA RELEASE

The ACA occasionally uses digital images taken at camp to communicate to camp families what activities are happening at camp each week / for program promotion.

YES, I authorize the use of my own / the student's photo in promotional materialsNO, I do not authorize the use of my own / the student's photo in promotional materials

Required: Please enter today's date