TREK 2017 Camper Application

CAMPER INFORMATION
Gender *

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Does applicant receive services from DDD (Division of Developmental Disabilities)? *
 
Will camper attend with a personal care attendant (PCA/Aid)? *
BIANJ DOES NOT PROVIDE PERSONAL CARE ATTENDANTS, NOR DOES THE PROGRAM PROVIDE ONE ON ONE CARE.
Seizures *
 
Are they controlled by medication?
 
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