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5. Camp phone number. Include area code.
6. Camp is profit-nonprofit. Check appropriate box.

7. Type of camp. Check all that apply. A camp may be described by more than one type. Residential camp-A camp in which campers live for a period of five days

or more and which is located on a specific parcel or parcels of ground.

These camps usually have permanent buildings and facilities. Travel camp-A camp which uses motorized transportation to transport

campers from one site to another in order to experience different

environments. Therapeutic campA camp for persons with special needs, for example:

blind, deaf, diabetic, emotionally disturbed, etc. Primitive campA camp which has little or no facilities and the campers

live, sleep and eat primarily out of doors Adventure camp-A camp which purposely provides many opportunities

for campers to engage in difficult activities and/or to live in extreme conditions and/or to penetrate remote wilderness areas. The camp pro gram may include such activities as mountain climbing, white water

boating, wilderness survival training, etc. Other-If any descriptions of camp type are given in addition to or instead

of the above, they should be listed. 8. Sponsorship. Check the appropriate box. If the camp name does not make clear its affiliation or status, then spell this out. Example: XYZ camp is a nonprofit camp which accepts campers from various agencies in a community.

9. Camp accredited ? Specify. List all accreditations which the camp may have.

10. Average camping fee per session. Round to nearest dollar, example: $25, $145, etc.

a. Self-explantory
b. Camperships are admittance to camp without charge.
C. A sliding fee is tuition aid to those campers of low income families

or other stresses. In other words, do certain campers pay according

to their family's economic ability ? 11. Camp policy? Check appropriate box.

12. Licenses or permits. Use supplementary sheet if necessary. When possible, specify the date of the last inspection as the month, day, and year. Use gross categories such as June, 1973 or Summer 1972 only as a last resort.

13. Bed capacity. Number of beds; Dining capacity. How many campers can be fed at one seating?

14. Qualifications of counselors. Describe any degrees, certificates, or other qualifications that are required to become a counselor at the camp. List separate qualifications for junior and for senior level positions if this is appropriate. As a minimum, the following items of information may be considered.

a. Minimum age
b. Certificates, licenses, or special qualifications such as life saving and

first aid skills.
c. Experience or qualifications such as previous camping experience,

previous counselor experience, attendance at training workshops or instruction periods prior to arrival of campers or prior to beginning

of camping sessions. 15. Camp operated by one or more than one director. A profile is completed for each change in sponsor. Hence this question refers to the directorship of the camp during one sponsor's occupation. Section B-Transportation

1. Types of vehicles to transport campers. Use appropriate descriptions of the vehicles, such as school bus, station wagon.

Frequency of use might be stated in many ways such as once a day, twice a session, often. If possible, get a frequency per unit of time even if it is an estimate. Avoid responses such as “often,” “infrequently," "occasionally."

Nature of use should be stated as specifically as possible. For example: "Trips to local recreation areas" rather than "Trips.”

2. Transportation to camp? Check appropriate box and list type of vehicle such as school bus, charter bus, train.

3. Licenses and qualification of vehicle operators. Note this question is to elicit those qualifications required by both the State or local government and by the camp. Qualifications might include minimum age, type of driver's license, and a statement of driving experience. To insure that all qualifications have been listed it might be beneficial, a iter all qualifications have been listed, to ask whether the director would hire someone to drive who came to him with those qualifications. This may bring out qualifications that are implicit such as he must otherwise qualify as a counselor. Seotion C-Medical and emergency facilities

1. Health personnel. Check all personnel available and indicate whether each individual checked is on call or in residence. Other special arrangements may include such things as having counselors thoroughly trained in emergency and first aid treatment, or taking all injuries to the local hospital emergency room.

2. How long! Record hours or minutes as appropriate.

3. Fire evacuation plan. In specifying “how often,” obtain a frequency per unit of time if possible, although an answer in terms of frequency per each group of campers may be perfectly acceptable. Acceptable answers would_be Once each week, on day of arrival of each new group of campers. Undesirable answers would be Very often, frequently.

4. Emergency transportation. Check all those forms available to the camp or describe emergency transportation arrangements that may not be listed.

5A. Camp Infirmary. If camp has an infirmary, indicate the number of beds.

5B. Legal consent means written consent, such as would be found on an application or medical examination form.

6. Physical required! Check appropriate box.

7. Parents notified! Specify guidelines the counselors or camp administration uses to determine if a parent is notified, for example, broken bones, emotional upset, upon advice of physician or medical attendant, etc. If a non-specific guideline is given, such as “In serious case," attempt to get at legst one example.

8. Are applicants with medical conditions accepted! Specify conditions such as chronic allergies, asthma, diabetes, congenital heart disease, seizure disorders, etc. Although replies such as “on our doctor's recommendation" or "judged on an individual basis" are acceptable, try to determine whether this recommendation or judgment means that the medical condition would require no special attention of camp personnel. Some camps are specifically equipped and staffed to handle special cases; others are not equipped to handle such cases, and this question attempts to distinguish the two. Section D_Waterfront

1. Number of staff certified. Determined the number of staff (not percentage or vague estimates such as “nearly all") certified at each level. Use only the highest level of certification. Example: if a camp has 10 staff members all certified as water safety instructors, the data will read :

Junior lifesaving-
Senior lifesaving-

Water Safety InstructorYou would not list the 10 as certified in Junior lifesaving and Senior lifesaving in addition to being Water Safety Instructors.

2. Where swim. Check apropriate boxes.

3. Rescue equipment. Check apropriate boxes and list any other equipment mentioned.

4. Water craft available. Specify number and types of watercraft such as sailboats, motorboats, canoes, rowboats, etc.

5. C.G. flotation devices. Check box.

6. When required to be worn! Try to avoid very general all encompassing statements such as "at all times” since they are probably not completely accurate. Usually there may be age limits or swimming ability limits. Wearing may be limited to anytime the camper is near the waterfront or whenever boating. Try to obtain fairly specific picture of the requirements.

7. Boating instruction pertains to special instruction for overnight camp trips 3 well as instruction for normal boating activities. : 8. Previous boating experience. This should include a listing of any safe "oating instruction or certification of boating instructors. Give special attention

qualifications of white water boating instrucors. 'eotion E-Other

Copies of rules, schedule, brochure.

These will be useful for clarifying answers in this and other forms when lata collection has been completed.

Comments.Insert any information that will clarify the answers on the torms or which will be helpful in understanding the camp situation. Sign your form.

CAMP CENSUS Section 1-General

a. Today's date. Use numbers for month, day, year. Example: 6/15/73 for June 15, 1973.

b. Camp name-self explanatory.

c. Camp ID number. A three digit number which uniquely identifies the camp for data processing purposes. - Section 2—8ession

a. Inclusive dates. Enter the dates (mo/day/yr) this session begins and ends.

b. Total days. Enter the number of days included in this session. Total days may not be the same as the dates the camp was in session if, for example, it is not operated on Sundays or weekends.

c. Name the organization (Boy Scouts, church group, etc.), corporation, partnersbip, or individual which gathered the campers together for the current session. Section 3Camper census

List the number of campers attending the session by sex and age. If precise numbers are not available for each age group then estimates should be made. A camp census with only a total number of campers is less useful than one with complete information. Section 4Counselor census

List the number of counselors at this session by the specified age groups. Section 5Camper activity census

An important item of information lacking in previous studies of camp safety is an indication of the amount of time campers are exposed to various activities some of which may be more hazardous than others. This question is an attempt to correct that deficiency. Although it may take some time to estimate the number of hours, number of campers, and number of counselors involved, it is beneficial to the study. Enter the information specified by camper activity. The "average number of campers in activity," and the “average number of qualified instructors present” both refer only to time when that activity is being conducted.

For example: Archery—10, 20, 3, means that archery takes 10 hours this session, participated by an average of 20 campers at a time, with 3 instructors present at the same time.

Activity 5d, Transit in conveyance," means the use of any group transportation during any part of the camp program (hayrides, travel, etc.). Be sure to exclude sleeping and eating time when you specify activities numbers 50, “Boating (overnight,” and 5t, “Hiking (overnight).” Eating and sleeping time should all be included under activity number 5a.

"Climbing (Technical),is rock, ice, snow, or mountain climbing where special equipment such as ropes, climbing hardware, ice axe, or other equipment should be used.

"Wide games,” activity 5v include a variety of games usually between two teams with the objective of capturing territory, property, or people. Examples: prisoner's base, capture the flag.

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Section 6-General camp schedule
Enter all times requested using a 24 hour clock.

8 a.m.=0800
11:30 a.m.=1130

Noon=1200 1 p.m.=1300

6 p.m.=1800
9:30 p.m.=2130

Midnight=2400
Specify any exceptions to the schedule.
Section 7Comments

Enter any information that will clarify the data given.
Signature

Sign your completed form.

CAMP ENVIRONMENTAL SURVEY

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Self-explanatory, Make certain that the correct ID number

is inserted. Responsible person: Enter name of person in charge of

camp (i.e. Director, Owner, or Manager). Enter address and phone number of responsible person if

different from camp address. Capacity of camp. The total number of persons that camp is

designed to hold. This number does not necessarily coin

cide with camp census number. Operating period : Circle the months of operation; Ex:

J F M equals January, February, March.

9.

10.-

Water Supply 11.

Water supply: Specify if water for drinking or culinary

purposes is supplied by a Municipal Agency or is camp

owned/operated. Self-explanatory.

12---
13 A, B, C, D.
E.

14 Note-uud

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A satisfactory reading of chlorine residual is one having

anywhere from a trace to 0.4 ppm (parts per million

available chlorine). This and other items in this form are designed so the in.

spector indicates that a condition either was or was not present (“Observed-Yes" or "Observed-No"), the condition was not inspected, or that the condition did not

apply to the camp (N/A). Unsatisfactory location: This item is observed when the

location of the camp owned/operated supply is located in a hazardous location. Ex: surface water intake located downstream from the camp sewage outfall or a well lo. cated in an area subject to flooding, or pollution source

less than 100 ft. from intake. Unsatisfactory protection: Ex: A well does not have a

sanitary seal, a spring is not enclosed properly. A cross connection is any direct connection between the

15---

16_

potable (drinking) water supply and a non-potable supply, including sewage. For the purposes of this item, any

possible connection between water and sewage. Self-explanatory. The chlorine mask is only necessary if gaseous chlorine is

being used. An observed hazard is the storage of the mask inside the chlorine room, a mask that is not oper.

able for any reason or the complete absence of a mask. Self-explanatory. Self-explanatory.

17 18_

19. 20, 21, 22.

ewage Disposal 3

Sewage disposal. Specify if sewage is disposed of by a

Municipal Agency or on the premises. 4

Self-explanatory. 5A

Check the type of sewage disposal used by the camp. More

than one type may be used. Ex: the kitchen may have a septic tank and the human wastes may be disposed of

into a privy. Slit trenches etc. are classified as "other.” 25B

Volume of septic tank: Enter volume of tank if known. If

unknown, so mark. 25C

Sewage treatment: Check only if the sewage treatment

facilities are owned/operated by the camp. Check the type of treatment. Chlorination: self-explanatory; Primary: settling. Imhoff tank, lagoon; Secondary : trickling filter, settling followed by lagoon, activated sludge, package treatment plant; none: check if the plant is being bypassed or direct discharge to a body of water; other : check if a “honey wagon" or other different type

of disposal is used and describe it. 25D.

Self-explanatory. Indicate name and type of body of water

(i.e. Ohio River, Mud Lake, etc.) 25E

Describe where sewage discharge is geographically located

relative to water supply intake. Ex: 12 mile upstream, 1 mile downstream, into a different and unconnected

body of water. 2830_

These questions will be checked where appropriate. If one

item is seen in more than one place, both places will be checked. Ex: Sewage on ground at the privy and septic tank. If the camp does not have a specific type of system,

leave blank. 31, 32.

If there is no effluent from a sewage plant, check N/A. 33.

See Question No. 18. 3A_

Self-explanatory. Solid Waste Disposal 35.

Solid waste disposal : Check "on-site" if the camp owns

and operates its own disposal site. If not, then check

“off-site." 36.

Self explanatory.
Check type of disposal facility used by the camp. A sani-

tary landfill must have garbage and trash covered by at
least 6 inches of dirt every day or at least every time
it is used. If this is not done, then check open dump.
Incinerator is self-explanatory, but is not open burning.

Other is all other types of disposal. Ex: compost heap. 38_

Self-explanatory. 39.

Self-explanatory. 40_

Solid waste disposal operation. Check observed if the dis

posal site is not a sanitary landfill in the strict sense of the word. The waste must be covered after each load is placed or once a day—whichever has the longest time

span. No blowing paper, open burning, etc. is allowed. 41.

Insect and rodent infestation. The insects or rodents do not

have to be observed to be checked observed. Insect and rodent signs (burrows, trails, droppings, etc.) are con

sidered observed. 42.

Self-explanatory. Lavatory Facilitics 43-

Number of lavatory facilities : This means the total num

ber of water closets, hand washing sinks, and bathtubs

or showers intended to be used by the campers. 44_

Self-explanatory.

:

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