Camp Director Checklist
To be completed ONLY if camp qualifies under the definition of summer camp or overnight camp
according to NY public health law. If camp does not qualify, please complete “Workshops for Minors
Checklist”
Camp Name _________________________Director/Coordinator_______________________
College/Division _________________________
Department _______________________
Camp Dates (list all) _______________________
Hours of Operation:_________________________
Residential Camp? Yes___________No________
More detailed information including access to online training and forms is available at
http://www.rit.edu/fa/grms/guidelines_for_minors.html
Date
RETURN TO:
M/D/Y
Staff Requirements:
□ NYS Prospective Children's
Camp Director Certified Statement (DOH-2271)
To be completed by Camp Director
______________
Human Resources
Brittany Zorn
Eastman 5th floor
Fax: 475-7170
Svc Statewide Central Register
Database Check (LDSS-3370)
To be completed by Camp Director
______________
Human Resources
Britany Zorn
□ RIT Background Check: Authorization
______________
Human Resources
Brittany Zorn
□ NYS Office of Children & Family
(Sex offender registry check)
To be completed by each volunteer and staff member
□ Camp Medical Director
______________
Must be hired with appropriate credentials
□ Camp Aquatics Director
______________
Must be hired with appropriate credentials if using deep end of GFH pool.
□ Training
______________
All staff must be appropriately trained on emergency procedures including but not limited to lost camper
protocols, emergency procedures, and identification and reporting of suspected abuse. More information,
including online training, is available at. https://www.rit.edu/fa/grms/content/workshop-and-programs-k12-students#overlay-context=content/minors-campus
Permit requirements:
□ NYS Dept of Health Children's Camp
Facility & Staff Description (DOH-367 & DOH-367a) _______________
To be completed by Camp
Director
□ NYS Dept of Health
Staffing Guidelines
□ RIT Camps & Workshops Safety Plan
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________________
N/A-Info only
(Provided by EH&S)
________________
□ CAMP BROCHURE
(Use standard brochure or modify with approval from
Risk Management)
__________________
Must also be distributed to parents during registration process
Registration requirements:
□ RIT Agreement to Participate (waiver)
EH&S – Jody Nolan
Grace Watson
Available on Risk Mgt
website
______________ Must be kept on file for 6 years
□ RIT Medical and Health Insurance Information and
Immunization History Forms
______________ Must be kept on file for 6 years
□ RIT Medication Form and
Medication Permission Forms
(if necessary)
______________ Must be kept on file for 6 years.
Hosting department is required to maintain in a secure location for a period of 6 years after conclusion of
camp:
 Current confidential medical history including proof of required immunizations.
 Health screenings and medication plans by qualified medical staff
 Release Agreement required for each participant (signed by parent/guardian)
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