Permission and Acknowledgement Form
Please fill out for all BOY and GIRL DIVISION (including TC) campers in your family.
Parent/GuardianName
*
First Name
Last Name
Child(ren)'s First and Last Name(s)
*
Acknowledgement of Receipt of Camp Policies and Activities
Permission to Dispense Over the Counter Medication
*Please note, if any prescription medication is warranted, please fill out the Administration of Medication form.
The camp has my permission to administer Diphenhydramine (Benadryl or generic brand) liquid, chewable or tablets depending on the ability of the child for allergy relief
*
Yes
No
The camp has my permission to administer Acetaminophen (Jr. Tylenol or generic brand) liquid, chewable, or tablets depending on the ability of the child reliever/fever reducer
*
Yes
No
The camp has my permission to administer Ibuprofen (Advil/Motrin or generic equivalent) pain reliever/fever reducer liquid, chewable, or tablets depending on the ability of the child
*
Yes
No
The camp has my permission to administer 1% Hydrortizone Cream (anti-itch)
*
Yes
No
The camp has my permission to administer Triple Antibiotic Ointment - 1st aid antibiotic
*
Yes
No
The camp has my permission to administer sunblock spray or topical cream
*
Yes
No
Permission to Release Children
The above children will be picked up upon dismissal by a parent/guardian or one of the following people.
*
The following children have permission to walk home independently.
Parent/Guardian Signature
*
Submit
Should be Empty: