Please complete the following Introduction Worksheet about your camper so

that we may get to know a bit more about them.

1.
What are the favorite activities of your camper:
_________________________________________________________________________________________

2. List some the favorite items that your camper likes to have or carry or play with. ________
_________________________________________________________________________________________
3. Will your camper run from an adult or out of the door?

Yes

No

4. Describe what your camper does when s/he becomes angry or frustrated: (no judgments
here!): __________________________________________________________________________________
________________________________________________________________________________________
5. Does your camper use pictures for communication?
Yes No
If so, when is the
easiest situation for them to be used?
________________________________________________________________________________________
6. What environments are the most difficult for your camper to be in? (ex. grocery store, in
a vehicle, in a classroom environment etc.) _______________________________________________
________________________________________________________________________________________
7. Does your camper act differently with different people in his/her environments? Please
explain. ________________________________________________________________________________
_______________________________________________________________________________________
8. Please add any information that you want us to know. _______________________________
_______________________________________________________________________________________
9. Does your camper have any allergies? ________________________________________________
10. Does your camper have seizures? ___________________________________________________
Camper Name: ______________________________________________
Date:__________________________