Camp Easterseals Nebraska
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Registration Forms


!    !    !
​All items in this section are MANDATORY
Due MAY 1


In addition to completing your camper's profile on CampDoc, you must also have completed the following forms. Please note, many require a legal guardian's signature.

Medical Packet

The Medical Packet is composed of 4 sections. All sections are due by May 1. If you have any troubles, please contact us so we can help.

Medical Form

The Medical Form must be completed within 12 months of attending their camp session. We also accept sports physicals. This must be signed by a doctor.

Medication List

The Medication List must include detailed information regarding all prescribed and over the counter medications taken by the camper. This must be signed by a doctor. *Note: medications must also be manually added in to CampDoc in a different section. They must match what is written on the Medication List.

Medical Protocols

The Medication Protocol Form must include all behavior and medical protocols set in motion by a medical professional. This must be signed by a doctor.

Immunizations

Immunizations must be current unless there is a medical reason. Tetanus expires every 10 years. Please attach immunization record.
2021: COVID Vaccine is not required for this year. However, if your camper has received it, please provide vaccination information.

Consent Form

The Consent Form must be read and signed by the camper's legal guardian. If the camper is their own guardian, the camper must sign it.

​Camper Rights & Responsibilities Form

The Camper Rights & Responsibilities Form must be read and signed by both the camper(if able) and camper's legal guardian. If the camper is their own guardian, the camper should sign both lines. A paper copy of this form will also be available upon Check-In.

Campership Application (optional)

If your camper is in need of financial assistance, first register for their session of choice, THEN send us the Campership Application ASAP. Before applying, be sure to read about our new Tiered Pricing Model.
  • Our funds are limited and dependent on our generous donors and most (but not all) of our Campership funds have income guidelines. 
  • Please apply early and be sure all information is complete. Applications will be accepted starting January and on paper only, NOT on CampDoc.
  • Please note that a copy of your most recent tax return, SSDI/SSI award letter, or proof of any other income listed on the application are required. Mail the completed form and required documentation to Easterseals Nebraska, Attn: Holly Windorski, 12565 W. Center Road Omaha, NE 68144 OR fax to 888-611-6396.
  • Camperships will be awarded on a first come, first completed, first serve basis! Notification of Campership Awards will begin in March 2020.
  • If you don't qualify for a Campership, please see "Alternative Funding Ideas" in the Payment Section to help you supplement your camper's tuition.
For more info on what to pack, medication instructions, our location, times, etc.,
visit the FAQ's section.
Easterseals Nebraska
12565 W Center Rd
Omaha, NE 68144
p: 402.930.4053
f: 888.611.6396
campesn@ne.easterseals.com
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  • Home
    • About
    • Our Programs >
      • Overnight Camp
      • Day Camp
      • Sampler Camp
      • Family Events
      • Camp at Home
      • Camp to You
      • Leadership Programs >
        • ChangeMaker Leadership Program
        • Nebraska Empowered Youth Leadership Camp
      • Off Season Events
    • How to Register >
      • Register
      • Waiting List
    • Forms
    • Payment Options
    • FAQs
    • COVID - 19
    • Other Easterseals Programs
  • Contact
    • Get In Touch
    • Work for Us
    • Volunteer
  • Photos
  • Ways to Give