2020 Chandler T.R.A.C. Camper Application
A Camp For Teens In Foster Care Ages 12-15
Thursday through Sunday
Fall Mini Camps Dates TBD
Please list ALL medications the teen is taking. Please include the following for each medication:
NOTE: MEDICATIONS MUST BE IN ORIGINAL PRESCRIPTION BOTTLES FROM PRESCRIBING PHYSICIAN. THIS IS NOT THE TIME TO GIVE MEDICATION VACATIONS.
Permission to administer first aid & over-the-counter medications.
This information must be confirmed by and signed for by the legal guardian who signs this application, which will take place after the application is reviewed.
Please check YES or NO for the medications listed below, which after the application is signed, gives our Registered Nurse permission to administer the following products according to manufacturer's instructions, or as otherwise specified.
If you have any of the following, you can upload them now. If not, you will be able to get us the information later. Respond to your confirmation email or use one of the methods below to get the following to us:
Alternate ways to submit the information (please include teen's first and last name with any correspondence):
* Email email@example.com OR reply to your confirmation email.
* Text 480-220-4925 with picture of requested item.
* Mail: T.R.A.C. CrossRoads Nazarene Church 2950 West Ray Road Chandler, AZ 85224
* FAX: 480-722-0770 attn: Sandy Schaumburg