2025 Health Form: Child with Sickle Cell

Licensed Medical Personnel Authorization
Authorization

I have reviewed the camper/sibling health history form and have discussed the camp program with the camper's parent or guardian. It is my opinion that the camper is physically and emotionally fit to participate in an active camp program (except as noted above).
Name of Licensed Provider*

First NameLast Name
Phone Number of Provider*
Please enter a valid phone number.
Email of Provider*
example@example.com
Signature*

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Health Form: Child with Sickle Cell Disease