Children's Camps

Department of Behavioral & Community Health


March 28, 2018


Dear Children’s Camp Director:

The following is a listing of required forms that must be completed and returned to the Dutchess County Department of Behavioral & Community Health (DBCH) by April 30, 2018.

  1. Application Packet which includes a NYS DOH-3915 form for a permit to operate a children’s camp, a checklist, and workman's compensation requirements.
  2. The Camp Safety Plan Affirmation Statement (DC HD-90) indicating by your signature that your camp’s previously approved safety plan accurately represents the policies, procedures and training that will be implemented during the current season. Any and all changes to your plan must be submitted to this Department for review and approval at least 30 days prior to your camp orientation. Safety Plan Templates are available on our Forms & Resources page for your convenience. A Safety Plan Template Addendum was developed in response to changed NYS requirements regarding campers with a physical or developmental disability. Please update your safety plan if any physically or developmentally disabled campers are enrolled.
  3. Children’s Camp Facility & Staff Description Form (NYS DOH-367) which requires basic data and information regarding program, enrollment and personnel changes from the previous year. It is essential that this form, as well as the Additional Staff Qualifications Form (NYS DOH-367a), contains complete and accurate information.
  4. Camp Written Plan Checklist Form (NYS DOH-2040)  to be used to determine if your written camp plan is in compliance with the requirements of Part 7-2 of NYS Sanitary Code.
  5. Children's Camps Amusement Device Survey to indicate the number and type of amusement devices at your camp. If your camp does not have any amusement devices, check the appropriate box and return the form.

    Do NOT mail the following forms to the state registry.

    Send them directly the Dutchess County Department of
    Behavioral & Community Health.


  6. State Central Register Database Check Form (NYS LDS-3370) to be completed by the Camp Director. Please follow the line-by-line instruction sheet.
  7. Prospective Children’s Camp Director Certified Statement Form to be completed by the Camp Director.

If you are unable to access any of the forms on this website, please contact the Dutchess County Department of Behavioral & Community Health at (845) 486-3404.

The Children’s Camps in New York State Brochure (NYS Publication 3603) must be provided to the parents of each enrolled camper. Printed copies may be ordered directly from the New York State Department of Health (NYS DOH) by calling (518) 474-5370, emailing a request to, or faxing a request to (518) 486-2361.

NYS DOH Required Certifications aka “Fact Sheets” which outline approved children’s camp staff certifications for personnel, first aid and aquatics. Please be advised if anyone on your staff requiring certification has taken a course that is not on the “Fact Sheets,” then that course is not acceptable until approved by the New York State Department of Health. Please note, online first aid and CPR courses are not acceptable. In 2016, we had several camps that had difficulty with certification for an Aquatics Director. The American Red Cross Lifeguard Management course (which is an acceptable class) requires an in-person test. Please see the Fact Sheet for requirements.

The updated meningococcal meningitis “Dear Parent” letter and updated meningococcal meningitis Vaccination Response form are linked, along with information from the New York State Department of Health on complying with Public Health Law. This law requires certain camps to inform parents about the risks of meningococcal meningitis. These signed forms must be kept on file and readily available upon request during camp inspections

Subpart 7-2 of the NYS Sanitary Code was amended in 2016, and now includes requirements for camps when any physically or developmentally disabled camper is enrolled. A FAQ document was forwarded to camps in 2016.
In addition, information is provided regarding the regulatory oversight of amusement devices such as high rope courses and ziplines at children’s camps. Camp operators who offer these and similar features at their camp must review this material and submit the Amusement Device Survey to DBCH. Please see the Department of Labor Reporting Offices for information should any injuries occur from these devices. Additional information about the Memorandum of Understanding/ Variance between the NYSDOH and the NYS Department of Labor is provided.

This year we are also coordinating with the Dutchess County Department of Human Resources regarding the operation of municipal camps. Failure to timely submit civil service paperwork to support appointment of camp, pool, or beach staff at a municipal camp is a violation of NYS Civil Service Law. The Dutchess County Department of Human Resources will be contacting municipal camps under separate cover regarding the necessary civil service paperwork required. Please comply with the requirements of NYS Civil Service Law. In addition, any municipal camps hiring staff through the civil service system are reminded to complete and return the Report of Personnel Change Form and Supplementary Payroll Certification Form (not provided in this correspondence) to the Dutchess County Department of Human Resources before the start of the camp operation. Further guidance and forms may be obtained from Human Resources at (845) 486-2169.
The Camp Director’s Resources website offers a variety of information about day and overnight trips for camp groups.

For further information or clarification of any of the required material, please contact:

Poughkeepsie District Office   Gena Mitchell              (845) 486-3404
Beacon District Office              Brandy Vadala            (845) 838-4801
Millbrook District Office            Kathleen Lizewski       (845) 677-4001
Wishing you a safe and healthy camp season!

James D. Fouts
Associate Public Health Sanitarian
Environmental Health Services

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A. K. Vaidian, MD, MPH,Commissioner of Behavioral & Community Health A. K. Vaidian, MD, MPH
Commissioner of Behavioral & Community Health
Dutchess County Seal