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  • Permission Form for Parents/Guardians to Complete

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  • Emergency Contact Information

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  • Student Care Needs

  • Does your child have any special needs (mental, physical, social, emotional, behavioral, etc.) or receive any sort of special support during the school year for reasons about which we should be aware?
  • Are there any “dietary restrictions” or “allergies” about which we should know?
  • Are there any prior health history or treatment about which we should know?
  • Are there any activities from which your child should be exempted for health reasons? For a list of activities, “risks” related to the activities, and degree of difficulty or physical challenge required by the activity, see www.cedarscamps.org/activities.

  • Camper Care Plan Acknowledgement

    CedarS Camps is classified by the American Camp Association as a “non-medical religious camp.” Our authorized care providers are Christian Science Practitioner. Dispensing medicine or treating campers under medical care falls outside their legal scope of services. If a camper requires any form of medication (prescription or over-the-counter), a Principia School representative will be responsible for their health-related care. A follow-up email will be sent to coordinate details with that representative. In accord with American Camp Association standards, prescriptions and over-the-counter medications are not allowed in camper cabins. In the case of epi-pens and inhalers, please contact the camp director for additional options.

  • Medications (check one):
  • Immunizations (check one):

  • Parent/Guardian Authorization for Treatment

  • Informed Consent and Acknowledgement

    I authorize and request CedarS Camps in cases of health emergencies to make any and all appropriate and reasonable health treatment decisions. I understand this may include but is not limited to engaging a Christian Science Practitioner, engaging a Christian Science Nurse, admitting my child into the camp’s Christian Science care facility, providing first aid/CPR, contacting emergency medical services, providing emergency transportation, and admitting my child into a clinic or hospital.


    I understand that effort will be made to contact a parent or other guardian before administering emergency medical care. However, if deemed necessary before contact can be made, I also grant permission for my child to receive such emergency care. 


    I understand the information on this form may be shared on a “need to know” basis with camp staff.

  • By acknowledging and signing below,

    I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.

  • Date
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