CRS BE 2025

Medical Information
Please list all known medical conditions.*
asthma, allergies, etc.
Is camper on medication?*
Is camper ALLERGIC to any medication?*
If yes, what med(s) is child on:
medication camper is on
If yes, what med(s) is your child allergic to:
medication camper is allergic to
Please note that all medications must be listed. Please understand that campers cannot keep their medications. A staff member will collect and distribute daily medications.
Is participant currently under the care of a doctor? If so, please include doctor's name & phone number.

Releases & Consents
MEDIA RELEASE: I give my permission for Bridges to allow photographs or interview statements of my child to be used as part of any publicity coverage that may occur including newsletters, public relations materials, or coverage by area media in regard to BridgesDHH programming.*

yes, my child can be in photos/videosno, my child may not be in photos or videos
Please Sign & Date*

Clear
Activity Consent

During Camp Rise & Sign, the camper will have the opportunity to participate in various activities including: bumper cars, rides and other park activities. As a parent/guardian, I understand the nature of these activities and give permission for my child to participate.
Activity Consent | Please Sign & Date*

Clear
Travel Consent

My child has my permission to be transported by BridgesDHH staff and volunteers for this field trip. BridgesEAST/BridgesDHH will not be held liable in the case of any harm.
Please Sign & Date*

Clear

We ask that you complete a form for each child, but please list the name(s) of other campers here for reference:
Should be Empty:

Medical Information