2026 Health Form: Sibling

  • Health Form: Sibling

  • Who is this form for?

    This form is for any Sibling attending Happiness Is Camping's Summer Camp.

     

    You can also download a paper form here.

  • If you've already completed a paper form, you can upload it here.

  • Date of Exam*
     - -
  • Date of Birth*
     - -
  • Varicella Status (please check all that apply)*
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  • Does the child have diabetes?*
  • Does the child have asthma?*
  • Does the child have any known allergies?*
  • Does the Camper have a history of psychiatric or behavioral issues?*
  • Are there any Over The Counter medications that should NOT be administered at Camp?*

  • Review of Systems

  • Rows

  • Physical Examination

  • Rows

  • 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).

  • Format: (000) 000-0000.
  • Should be Empty: