Bold Explorers Application – West Texas Camps and Retreats

Bold Explorers Camper Application

Explore, Grow & Shine - Bold Explorers is a one-of-a-kind camp experience designed specifically for blind and visually impaired children, ages 11-14.

This four-day session gives campers the opportunity to explore new adventures, grow in confidence, and shine as the unique and capable individuals they are — all within a safe, supportive environment built with them in mind.

Each session is intentionally limited to 18 campers, ensuring every child receives the individual attention and care they deserve. Our trained, compassionate staff and volunteers are dedicated to making each camper feel known, valued, and celebrated every single day.
Bold Explorers is provided by West Texas Camps & Retreats at Circle Six Baptist Camp in Lenora, TX. For complete session details, what to bring, and everything you need to know, download the Camper Information Packet.

To reserve a spot for your child, a parent or guardian must first complete a camper application. Applications are reviewed by our team, and families will be notified of their acceptance within 5 business days. Upon approval, registration forms will be sent for complete enrollment. Because each session is limited to 18 campers, space fills quickly — we encourage families to apply early to secure their child's place at camp.

Camper's First Name

Camper's Middle Name

Camper's Last Name

Date of Birth

Age

Last Grade Completed

Parents or Guardian

Street Address

City

State

Zip code

Primary Phone

Does This Phone Recieve Text

Yes No

Secondary Phone

Does This Phone Recieve Text

Yes No

Has your camper attended an overnight camp berfore?

Yes No

If yes, please tell us about thier experience. (Did they enjoy camp, challenges with camp, etc.)

What are your camper's strengths and interests?

What goals do you have for your camper at camp?

What is the camper's visual diagnosis?

Does the camper have secondary diagnosis in addition to a visual?

Yes No

If yes, please provide additional information.

Can the camper independently complete personal care tasks such as bathing/showering and using the restroom?

Yes No

If assistance is needed, please describe the level of support required:

Is the camper able to feed themselves independently, or do they need assistance during meals?

Yes No

If assistance is needed, please describe the level of support required?

Can the camper communicate basic wants, needs, and safety concerns to others?

Yes No

Does the camper frequently runaway or wander away from their group?

Yes No

My child can be kept safe without constant physical intervention?

Yes No

Does the camper engage in any of the following behaviors? Check all that apply.

Hitting, kicking, biting, others Self-injurious behavior. Verbal threats or aggression against others None of the above

Does the camper require specialized behavior or support?

Yes No

How does the camper respond to structured group activities?

Camper can transition between activities with basic prompting?

Yes No

Can the camper tolerate small changes in routines and follow a simple daily schedule?

Yes No

Is the camper able to sleep in a dorm room?

Does the camper require overnight support? (Examples: visual monitoring, assistance if woken, nighttime toileting, comfort routines, etc.)

Yes No

If yes, provide details

Does the camper wander at night?

Yes No

Camper's medical needs are stable and do not require specialized care?

Yes No

If no, please describe required care.

Camper's medications (if any) are routine and clearly scheduled?

Yes No

"Does the camper use any tools or aids to help them communicate or access information (e.g. large print, Braille, assistive technology, AAC device)? If so, please describe:"

Does the camper use a white cane, human guide, both or neither?

If the camper uses a white cane, what is their current level of proficiency?

Beginner Developing Proficient Traveler

Please share any additional details about their mobility and travel skills:

Are the camper's vision or comfort levels affected by lighting conditions such as low light, bright light, or glare? If so, please describe:

Will the camper be bringing a guide dog to camp?

Yes No

By checking the box below, I acknowledge that the information provided in this form will be used to assess whether this camp setting is appropriate and safe for my child. As the parent or guardian, I confirm that all responses are accurate and complete to the best of my knowledge.

I confirm and agree

I understand that West Texas Camps and Retreats staff and volunteers are not licensed medical or clinical professionals. While all volunteers receive camp-specific training, I acknowledge that the care and support provided during the session is not equivalent to professional clinical care. I agree that it is my responsibility to ensure my child's medical and therapeutic needs are communicated fully on this form.

I understand and confirm