Medical Form for Youth Camp

There will no longer be a need to fill out a medical form at camp or print one out. Once completed, it will be sent to the camp nurse before your child goes to camp.

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Camper Name: *

Birthdate: *

Does your child have any physical, emotional, mental, or behavioural concerns or limitations that our staff should be aware of? If it is found that any of the above concerns or limitations have not been disclosed, we reserve the right to send the camper home without a refund. *

If yes, please explain:

Please list any allergies or dietary (food, Medication, etc.) restrictions: *

If camper has any medications with them, please include instructions here for camp nurse.

All Medications MUST be labeled or the camp nurse CAN'T administer it. Thank you for your understanding!

Emergency Contact Information:

First Name of Parent/Guardian 1: *

Last Name Parent/Guardian 1: *

Phone Number of Parent/Guardian 1: *

First Name of Parent/Guardian 2:

Last Name of Parent/Guardian 2:

Phone Number of Parent/Guardian 2: