Camp Button 2018 - Parent Assessment
  • Participant Information

  • / /
  • - -
  • - -
  • - -
  • Medical Information

  • Mobility

  • Communication

  • Behavior/Personality

  • Social

  • Cognitive

  • Personal Care

  • Safety

  • Swimming

  • Authorization to Contact and Release of Information

    Unless otherwise indicated, I grant permission to Groton Parks and Recreation to contact the school, teachers assistant, teacher, social workers, therapist or physician for the purpose of gathering or releasing information regarding this participant. The information will be used to provide the most effective plan for providing recreation services and proper placement in inclusion. All information will be kept confidential.